["HMO plans may offer reduced benefits for care received outside of the network.","Active employees are not eligible for Retiree Medical Coverage, so you would temporarily lose this coverage while employed.","Premium: The total premium for couples enrolled in the plan.","Whether you choose to enroll in any of these programs is completely optional and voluntary.","The evidence must be reviewed and approved by the claims office before any benefits will be paid under this provision.","Disability benefits from an accumulated sick time or salary continuation program, provided they are part of an established group plan maintained by your Employer for the benefit of its employees.","State Insurance Commissioner, if applicable.","Sorry, currently no updates on this topic.","Provider participation may change without notice.","If your group plan includes a separate disability feature applicable to life insurance, coverage for a totally disabled employee may be continued beyond the limits shown in your plan documents.","This may include content you provide for publication.","One of you may enroll in a coverage level that includes dependents, with the other covered as one of your dependents.","Amazon employee or household member.","Is licensed and certified as required by any state or federal law or regulation.","The decision to do so may be the result of changes in federal or state laws governing benefits, or any other factor.","Any other income benefits you are eligible for may affect your benefits from this Plan.","The plan covers charges made for services and supplies only while the person is covered under the plan.","This means you have taken onthe legal obligation for total or partial support of a child whom you plan to adopt.","You are responsible for the cost of compiling and sending the information that you wish to be reviewed by the External Review Organization to Aetna.","Aetna does not require a copy of the Right of Continuation Notice.","BP Medical Plan and other group health coverage, the BP Medical Plan will not be the primary plan.","Disabled Dependent Children Health coverage for your fully disabled dependent child may be continued past the maximum age for a dependent child.","The site provides access to background checks, references and reviews from other users.","Prudent Actions by Plan Fiduciaries In addition to creating rights for plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan.","Has a psychiatric physicianpresent during the whole treatment day.","PTO program provides employees more choice in when and how to use time off.","If you participate in an HMO, all of your health care must be provided by the HMOs network of providers to receive benefits.","Your plan documents can tell you the specific terms that apply to your group plan.","Aetnawill provide a written notification to you and your physicianof the precertificationdecision.","MRA, CT scan, PET scan and nuclear imaging.","The IOEfacility must be specifically approved and designated by Aetnto perform the procedure you require.","No benefits will be paid for any charges for services rendered or supplies furnished under an HMO Plan.","Member Services can answer your questions.","COBRA direct billing services.","Simply log in with your existing ID and password.","Medicare offset and will be applied on the basis that the Medicareeligible person is enrolled in Medicare Part A and Part B, even if the person is not actually enrolled in Part B or is not Medicareeligible.","Complete the online Financial Fitness Assessment to receive a personalized report with key action steps to improve your financial wellbeing.","Our plans also offer features that can help you today.","Services rendered by a family member.","Review your health care coverage.","Each insurer has sole financial responsibility for its own products.","Your HSA Information will be accessible through any of these three options.","The Aetna health care plan covers both pharmacy and mental health benefits.","If the expense is covered under any other plan, you cannot be reimbursed through the RRA until the expense has been considered by the other plan.","Accounts for domestic partners and retirees will be charged small monthly fees.","These images are placed on a web page or email and typically work in conjunction with cookies to collect data.","BP may take remedial action against you with respect to your employment.","The amount of life insurance coverage up to which an applicant is guaranteed coverage under the group plan without needing to provide Evidence of Insurability.","Leave of Absence and continuation of benefits for military reservists.","Charges for the expenses are made by a home health care agency; The care is given under a home health care plan; and The care is given to a recipient in his or her home.","Aetna has the right to evaluate you for participation in an approved rehabilitation program.","Or the amount payable by an insurer to a person making a claim, assignee or beneficiary under each coverage in a group contract.","In these plans, prescription drugs may be covered at lower copays if they are preferred and higher copays if they are nonpreferred.","JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.","HSA has been established.","Your broker can provide you with a list of valid waivers.","Once you enroll in a Dependent Care FSA, you cannot drop or make changes to this benefit, unless you experience an eligible status change or qualifying life event.","In most cases, the policy must remain in force for the provision to apply.","Please know that your report is not a substitute for medical care and cannot be used to diagnose health problems.","Benefits for such claims will be paid to the custodial parent.","We reserve the right to modify or discontinue such arrangements at any time.","Website, please remember that it is your responsibility to safeguard them.","Some HMOs may impose more restrictive criteria.","Mths imp: The number of months affected by the transaction.","Expenses covered under the BP Medical Plan sections in this SPD for a description of these services.","This lets you take your coverage with you if you leave the company or you retire.","Generally, we rely on our legitimate interests in order to process your personal information.","Eat healthy and save on your grocery trips this year.","Court ordered services, including those required as a condition of parole or release.","An assignment is the transfer of your rights under the group policy to a person you name.","Aetna will rely upon the representation of the employer as to your eligibility for coverage under this plan and as to any fact concerning such eligibility.","We place our own cookies on your computer to track certain information about you while you are using our Website and Services.","Please send the bill to the address listed on the back of your member ID card and Aetna will resolve any payment dispute with the provider over the amount.","Provides, at all times, psychiatriccial work and nursing services.","However, the appeal is voluntary and you are not required to undertake it before pursuing legal action.","Coverage includes counseling services on contraceptive methods provided by a physician, obstetrician or gynecologist.","Treatment of mental retardation, defects, and deficiencies.","If you are dissatisfied with the appeal decision on an urgent care claim, you may file a second level appeal with the claims administrator.","Your investment options include Asset Allocation, Fixed Income, and Equity Funds.","An independent review organization refers the case for review by a neutral, independent clinical reviewer with appropriate expertise in the area in question.","All expenses related to care that has not been precertified are reviewed by the claims administrator.","Complaints to the plan or to the Privacy Officer should be filed in writing with: BP HIPAA Privacy Compliance Monitor BP Corporation North America Inc.","You may make a verbal inquiry to the BP Benefits Center if you have a claim related to such issues as: Eligibility to enroll in the plan; Enrollment elections; or Qualifying status changes.","It will indicate any amounts you owe toward anydeductiblecopaymentpayment percentage, or other noncovered expenses you have incurred.","You are about to close this Web Part.","Move your HR career forward.","Fairview offers five medical plan options.","For example, if you marry you may add your new spouse to your Health Care Plan, but you may not enroll in the Dental Plan if you had not been previously participating.","You must pay the required contribution in full or coverage will not be effective.","Covered expenses also include the rental or purchase of breast feeding equipment as described below.","If you are injured at work, notify your manager or supervisor as soon as possible.","Please refer to the Schedule of Benefitsfor any substance abusedeductibles, maximums and payment limits maximum outpocket limitsthat may apply to your substance abusebenefits.","It must not be due to, or contributed by, an illnessor disease of any kind.","Approved Rehabilitation Program A written program, approved by Aetna, that provides for services and supplies which are intended to enable you to return to work.","This is usually done to balance changes in the supporting tissues.","All employees are covered by professional liability insurance while performing assigned duties within the scope of their employment at Fairview.","Food items: Any food item, including infant formulas, nutritional supplements, vitamins, including prescriptionvitamins, medical foods and other nutritional items, even if it isthe sole source of nutrition.","Fairview provides tuition and initial certification reimbursement for eligible employees.","If you already have coverage but are adding an eligible dependent, you may not switch BP Medical Program options.","Information can be found on the Human Resources website, hr.","Benefits are also provided for certain preventive care, as well as for behavioral health care and prescription drugs.","Any such plan is prior coverage if provided by another group insurance plan.","Dependent care benefits are provided by an employer to an employee for use in caring for dependents, such as young children or disabled family members.","Sea precavido cuando lea este texto traducido.","The goal is to let terminally ill patients remain in familiar surroundings for as long as possible.","If your plan includes insured coverages and you want to produce your own Summary Plan Description, we are happy to provide you our privacy policy.","Any attempted assignment to a medical provider will be treated as a direction to pay benefits to such provider rather than as an assignment of rights.","It is your responsibility to contact UPS with this information.","Certain drugs such as Insulin, Imitrex, Epinephrine and Glucagon are not considered specialty drugs.","Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.","Forms used to give notice of intent to return to City employment from active military leave.","What are the qualifying reasons for which an employee can request leave under the FFCRA?","These visits are included in the delivery charge.","Results in any way from an illness or injury which does.","Only copies of actual court documents issued by the respective courts will be considered as acceptable documentation for dependents.","The participant shall fully cooperate with the plans efforts to recover its benefits paid.","BP retirement program when you left BP; and The BP business unit for which you worked.","The BP Benefits Center will then mail COBRA enrollment materials to the affected family member.","Except for Aetna RX Home Delivery LLC, roviders of health care services, includinghospitals, institutions, facilities or agenciesare independent contractors and are neither agents nor employees of Aetnaor its affiliates.","Fidelity Dedicated Retirement Planner.","Confidentiality Notice Aetna considers personal information to be confidential and has policies and procedures in place to protect it against unlawful use and disclosure.","Plan features may vary by location and are subject to change.","Services obtained from a facility that is not designated as an IOE for the transplant being performed will be covered as outservices and supplies, even if the facility is a network facility or IOE for other types of services.","The timing of the annual renewal greatly affects the service your members receive.","What this means to youis that the recognized charge is based on the version of the rates that is in use by Aetna on the date that the service or supply was provided.","NIAGARA WATER does not receive any consideration in the form of cash or otherwise in connection with the program, other than reasonable compensation, excluding any profit, for administrative services actually rendered in connection with payroll deductions.","Treatment of a covered health care provider who specializes in the mental health care field and who receives treatment as a partof their training in that field.","Any medically necessary and reasonable health expense, part or all of which is covered under any of the health benefits or health insurance plans of the member for whom the claim is made.","Typically, your pharmacist will fill your prescription with a generic drug, if available, unless you or your doctor specify otherwise.","Requesting generic prescriptions is one of the easiest ways to potentially save money on your overall medical costs.","Alter the jaw, jaw joints, or bite relationships by a cutting procedure when appliance therapy alone cannot result in functional improvement.","Service provided after a patient is admitted to the hospital.","It is licensed or approved under state or local law.","Results from a motor vehicle accident caused by operating the vehicle while you are under the influence of alcohol.","For longerterm maintenance prescriptions, you must use the home delivery service.","Keep in mind that your issue may not necessarily be resolved in your favor, as the terms of the plan will apply in all situations.","The longest time period for which disability benefits are payable, once all plan conditions are met.","There is no deductible that the employee is responsible for.","Vermont, Rhode Island, and California.","Employees in states with State Disability Insurance must apply for SDI.","Consider using the RRA to help with medical premiums up to the time you are eligible for Medicare.","Similarly, covered outnetwork expenses count toward meeting the outnetwork medical coverage deductible, but do not count toward meeting the network medical deductible.","To accomplish this Service, we embed code that such third party social networks provide and that we do not control.","The date you become eligible for benefits under any other disability plan of this type that is offered by your employer if this date falls after the date the group contract ends.","Treatment of antisocial personality disorder.","You should keep your receipts for all expenses.","The box or boxes showing who is eligible for COBRA.","Teladoc is intended to treat minor nonemergency conditions such as: Respiratory infections Ear infections Urinary tract infections Colds and flu Sore throat How to use Teladoc Set up an account via Complete your medical history.","In the absence of coverage under this Plan, you would have been eligible to receive benefits for that disability under the prior coverage.","The partial hospitalizationwill only be covered if you would need inpatient treatment if you were not admitted to this type of facility.","MSU Human Resources, or Delta Dental.","Initially, a disability is one that prevents you from working at your own occupation.","Health Solutions provides Medical Management and Care Coordination.","This is called group term insurance or group coverage.","Have more control over when and how you spend your health care dollars.","Physical therapy does not include educational training or services designeto develop physical function.","Coverage for Home Health Care services is not determined by the availability of caregivers to perform them.","You cannot be reimbursed from both accounts for the same expense.","Ask your employees to sign up for the secure member website through www.","There are many types, including term life, whole life, group universal life and others.","DLW is changed to previous day worked.","Disability, retirement or unemployment benefits required or provided for by government law.","It is the process followed for an insurance requirement policy given by a university or state regulation.","Amazon is continually evaluating new ways to provide other types of ownership opportunities for all employees.","Services provided where there is no evidence of pathology, dysfunction, or disease; except as specifically provided in connection with covered routine care and cancer screenings.","This means you will be responsible for the unpaid balance of any bills.","Mainly provides inpatient hospice careterminally illpersons.","What Is JD Supra?","Summary of Coverage or Benefits.","The reasonable unforeseeable consequences of a voluntary act by the person.","You can go to one of the thousands of pharmacies nationwide that participate in the CVS Caremark network.","Another way of helping working parents with childcare costs is when employers have a relationship with a local childcare centre, which in turn benefits the worker in terms of the discounted fees that can be negotiated.","You are responsible for paying any charges above the recognized charge Eligible claims incurred in an emergency room facility will be covered at the applicable innetwork benefit level.","We distribute this to members as the law requires.","You pay the first portion of contracted or recognized charges for most covered expenses incurred by you and each covered dependent during the plan year before the plan begins paying benefits.","Has individualized active treatment plan directed toward the alleviation of the impairment that caused the admission.","This form confirms the information you gave your employer, including the dates and reason for your leave.","All other screenings and tests are covered based on age, gender and medical history.","The guides and resources cover the life cycle of a staff member from recruitment to leaving Rice.","PETplus Prescription Savings Plan will save you money on the products your pets are already using.","You may be trying to access this site from a secured browser on the server.","What is Egg Freezing?","Provide a valid search term to submit this form.","BP HSA contribution by following the procedures above.","For example, educational services and certain types of therapies are not covered.","These drugs are under patent protection.","Aetna processes all terminations using the last day of the billing cycle month.","If your short term disability coverage ends, you may reinstate coverage subject to the rules described in the When your Coverage Begins section.","Aetna Choice POS II network provider option available, Aetna may treat a nonnetwork provider as if it were an innetwork provider until a viable Choice POS II network provider becomes available.","You have successfully completed this document.","Hartford Life and Accident Insurance Company and Hartford Fire Insurance Company.","Available through telephonic or virtual coaching, you work oneone with a trained health coach to achieve your wellbeing goals.","Telephone, television, internet, barber or beauty service or other guest services; housekeeping, cooking, cleaning, shopping, monitoring, security or other home services; and travel, transportation, or living expenses, rest cures, recreational or diversional therapy.","Coverage will cease on the first to occur of: Cessation of the disability.","Covered transplant expenses are typically incurred during the four phases of transplant care described below.","All new hire packets will need the employee manual printed up for the employee if they would like OR they can download the digital copy from this page.","Fairview reserves the right to modify, change or reserve any part or parts of this information at any time.","Recognized charge limits do not apply to: Eligible expenses provided by a network provider under the PPO Options.","Other Eligible Individual relationship, etc.","All itemized bills indicating the date of service, description of service provided, diagnosis, name of the provider and charges incurred.","You, and not BP, own that account.","The resources on these pages were created specifically for faculty and staff members who are responsible for managing and supervising Rice University staff members.","Expatriate Medical Plan administered by Cigna International.","We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff.","If you are enrolled in the Standard Option, you must first meet the Prescription Drug Program plan year deductible before you receive any reimbursement.","Income means income you earn, while disabled and working, from your employer or any other employer.","Routine eye exam: The plan covers expensesfor a complete routine eye exam thatincludes refraction and glaucoma testing.","Make sure you keep your original statement.","Participant contributions are set by BP and may be adjusted from time to time.","If you file a voluntary appeal, any applicable statute of limitations will be tolled while the appeal is pending.","The administration of certain immunizations administered within the scope of the clinics license; and Individual screening and counseling services to aid you: to stop the use of tobacco products; in weight reduction due to obesity; in stress management.","In this regard, a participant may be asked to provide information and documentation supporting a covered dependents status as an eligible dependent.","Roomand board, up to the semiprivate room rate.","To find forms customized for your benefits, log in to your member account.","Click on the summaries above for details.","Your People department representativewill provide any required documentation at the time of your request.","This means that even if you change health plans, take a new job or retire, you can still use the money in the account to pay for eligible expenses.","Disable select boxes with no value selected.","COB rules generally apply to group insurance plans, nofault auto insurance and Medicare.","If you choose to use our Website and Services to communicate directly with a company or individual, such communication may be shared accordingly.","Also, as with all other plan benefits, you are not eligible to participate in the wellbeing program unless you are a participant in this plan.","Aetna may, in its sole discretion require you to participate in an approved rehabilitation program.","Hire the best HR talent or advance your own career.","How Your Medical Plan Works Common Terms Accessing Providers Precertification It is important that you have the information and useful resources to help you get the most out of your Aetnamedical plan.","Visionrelated services and supplies, except as described in the What the Plan Coverssection.","We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status.","For example, we use them to remember your preferences for the next time you visit.","Precertification of maternity care is not required.","Employees or their dependents may be able to enroll in the plan as late enrollees.","We may also require examination of the child as often as needed to determine continued eligibility.","HMOs are subject to the same rules regarding health care claims that apply to the BP Medical Plan.","Skilled nursing and other therapy provided by a home health care agency in the home instead of in a hospital or skilled nursing facility.","The External Review Organization will select an independent clinical reviewer with appropriate expertise to perform the review.","Receive free membership to Sittercity and Years Ahead, a portal to locate qualified child care or elder care.","The same deductibles and coinsurance limitations apply to these procedures as apply to any other illness.","Federal Law prohibits dispensing without prescription.","Has a utilization review plan.","Provides an ongoing quality assurance program including reviews by physiciansother than those who own or direct the facility.","Future financial security for your loved ones.","If you are enrolled in an HMO and have benefit questions, contact your HMOs member services department for answers at the phone number listed on your HMO ID card.","They will be paid at the end of each week during the period for which benefits are payable.","FMLA also allows employees to take leave to care for a covered service member or veteran with a serious injury or illness if the employee is the spouse, son, daughter, parent or next of kin of the service member or veteran.","Office visit copays and urgent care facility copays do not apply to the plan year deductible; however, they do apply to the outpocket maximum.","We encourage you to read the legal notices posted on those sites, including their privacy policies.","To the extent permitted by law, we use and disclose personal information as provided above without member consent.","The notice will explain the reason for the denial and the appeal procedures available under the Medical Plan.","HSA Plan and the HMO Plan.","You can also learn more at hr.","Not all forms may apply to your coverage and benefits.","ESI pharmacists will not make any changes to your prescription unless authorized by your doctor.","Specifically, the following penalties will apply: If you do not call to precertify.","Try finding it in our glossary.","Precertification is not required for expenses incurred while you are outside the United States.","Attempting to insure someone who is not eligible may result in disciplinary action, up to and including termination of employment.","Your session has expired.","Be prepared: know where and how to access these services to save time and money.","You can retire at any time and keep the RRA credits that accrued before you transferred.","Speech function is the ability to express thoughts, speak words and form sentences.","Privacy Policy immediately below for more information about how you may request that we limit or refrain from processing your personal information.","And choosing a primary care doctor to lead your care team will help give you the personal care you need to reach your health goals.","Each PPO Option also includes a Prescription Drug Program, administered by Express Scripts, Inc.","RSU vesting will be proportional to the option you select.","The NAP network consists of many of Aetnas directly contracted hospitals, ancillary providers and doctors, as well as hospitals, ancillary providers and doctors accessed through vendor arrangements where Aetna does not have direct contractual arrangements.","Who Is Eligible Your employer determines the criteria that are used to define the eligible class for coverage under this plan.","You are in a BP HMO or PPO and you move outside the HMO or PPO service area.","Validate the username and retrieve security questions from web method in Presenter.","Get in shape and save money.","HIPAA discrimination concerns when operating their plans.","Failure to have any required exam.","Each IOEfacility has been selected to perform only certain types of transplants.","If you experience an injury at work, the table below explains how to report this type of claim.","This means you may need to use more than one form for your workforce.","To complete the enrollment process, you will need to provide all requested information for yourself and your eligible dependents.","Aetnagiveservices or supplies to an IOEpatient in connection with specific transplantsproceduresnegotiated charge.","FMLA leave has ended.","Privacy Policy, or subsequently authorized.","Attention Florida Residents: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete or misleading information is guilty of a felony of the third degree.","If your claim is denied in whole or in part, you may appeal the adverse benefits determination by submitting an appeal to the claims administrator for appeals in care of ERISA Claims and Appeals.","For example, list dependent children attending school.","Please return this portion with your payment.","Complex case management is for participants with an acute condition such as a severe stroke, transplant, severe injury or cancer that requires extensive treatment.","Check your invoice carefully.","Because HMOs are generally insured, they may be subject to claims and appeals rules and procedures under applicable state laws that provide participants even greater potential procedural protections.","Walmart, Walgreens, CVS, and more!","Constitution State Services Co.","In order to get credit for a month, you must work the entire month in order to obtain credit.","Working spouse and dependent eligibility rules may apply.","Items placed here to avoid compiler.","Plans may not impose annual and lifetime dollar limits on Essential Health Benefits if offered.","Indicates that the cost of a group insurance plan is made in part by the employer and in part by employees.","The Hartford is not responsible and assumes no liability for the goods and services described in this material and reserves the right to discontinue any of these services at any time.","By phone The BP Benefits Center online: You can: Enroll in BP health and protection benefits.","Satisfy each of the following requirements for at least six full months before signing a Domestic Partner Affidavit.","You may not be enrolled in the Retiree Medical Plan and be a BP employee at the same time.","The PPO Options are available only if you live in an area where the Aetna Choice POS II network is available.","BP Medical Plan if: The item is not expressly treated as covered under the plan.","The date you are first eligible to sign the affidavit is the date your partner will be considered your domestic partner for plan purposes.","Primary care physician who often acts as the primary gatekeeper in health plans.","Patient is a candidate for, or recipient of, an organ or bone marrow transplant.","Flex card claim form.","The inability to perform the functions of any job because of an illness or injury.","From one hospitalto another hospitalin a medical emergency when the first hospitaldoes not have the required services or facilities to treat your condition.","Schedule of Benefitsfor any applicable deductiblecopayand payment percentageand maximum benefit limits.","Whether you do this is up to you.","The subscriber can sign up eligible dependents, as determined by the policy, under family coverage.","You will receive one medical ID card with your Aetna Medical plan on the front and your Magellan Rx plan on the back.","Internet site at www.","See Preventive care for details.","Benefits Card to pay for qualified health care expenses up front.","Contact MSU Human Resources whenever the status of a dependent changes.","Medical social services under the direction of a physician.","If you are unable due to a medical condition to participate in any of the healthrelated activities or achieve any of the health outcomes required to earn an incentive, a reasonable accommodation or an alternative standard is available.","The medicine may start as a powder that is mixed with water.","Aetna will provide certain administrative services under the Aetnamedical benefits plan.","You must satisfy any applicable deductiblesbefore the plan begins to pay benefits.","Paper enrollment is required for this benefit.","The planthat covered the person as an employee, member, subscriber longer is primary.","Check if your preventive drugs are covered.","If your Employer grants you an approved FMLA leave in accordance with FMLA, your Employer may allow you to continue coverage for which you are covered under the group contract on the day before the approved FMLA leave starts.","Coordinate care approvals for an upcoming surgery or procedure.","If you had already satisfied the probationary period before you entered the eligible class, your coverage eligibility date is the date you enter the eligible class.","Prescription drug expenses do not apply to the medical plan deductible.","For example, the plan does not cover therapy when it is used to improve speech skills that have not fully developed.","This includes episiotomy and repair of perineal tear.","This includes lessons in sign language.","The maximum benefit that will be paid under the Policy for all Covered Medical Expenses incurred by a Covered Person that accumulate from one year to the next.","To obtain precertification, call Aetnathe telephone number listed on your ID card.","Health Savers Plan includes an HSA, which you can use to pay for the same types of medical, dental, and vision expenses.","Emergency Paid Sick Leave Act and the Emergency Family and Medical Leave Expansion Act?","Covered dependents not eligible for Medicare may apply for individual coverage even if you are eligible for Medicare.","But what if a disabling illness or injury prevents you from working?","Invest for the first time or increase your investments to be eligible for this incentive.","Some of these arrangements may be made available through third parties who may make payments to Aetnain exchange for making these services available.","They may also be subject to precertification or step therapy.","There is no additional cost to you for this service.","If the volume of charges is not sufficient to produce a statistically valid sample, two or more threedigit zip codes are grouped to produce a statistically valid sample.","Call the phone number on your invoice.","Plan members control which doctors they see.","Choose from a wide variety of personal financial topics.","The Medical Plan will also recognize a court order giving a person authority to submit claims on your behalf.","You only pay your applicable prescription drug copay.","To close this Web Part, click OK.","Leave due to qualifying exigencies may also be taken on an intermittent basis.","The plan will cover charges in accordance with a treatment plan as determined by your risk level when recommended by a physician.","Delta Dental will return form to dentist indicating amount covered under plan.","To obtain a copy of the HIPAA Notice, please click or contact the BP Benefits Center.","Your browser does not support the video tag.","Once you meet the separate prescription drug deductible, you will pay a copay for generic drugs, or the applicable coinsurance for preferred or nonpreferred brand name drugs.","Calling about an employee?","This includes reviews by physiciansother than those who own or direct the facility.","If the current value equals the default value, clear it.","For purposes of BP health care programs, domestic partners and civil union partners are offered continuation coverage comparable to the coverage offered to covered spouses under COBRA.","You may file a voluntary appeal for External Review of any Adverse Benefit Determination or any Final Internal Adverse Benefit Determination that qualifies as set forth below.","Uses volunteers trained in providing services for nonmedical needs.","Important: If a person is eligible to convert their coverage to an individual insurance policy from their group health plan, they must do so when applying for any extension of benefits.","FMLA, any extended continuation of coverage during that period will be subject to approval by Aetna, which will have sole discretion to continue or discontinue the coverage for that extended leave period.","If you are successful, the court may order the person you have sued to pay these costs and fees.","An exam will not be required more often than once each year after two years from the date your child reached the maximum age under your plan.","Certificate without regard to any claim of fault on your part, whether by comparative negligence or otherwise.","If the plan or health insurance coverage designates a primary care provider automatically, then until you make this designation, Aetna designates one for you.","You may also receive paper statements on a regular basis.","Aetna to be a covered benefit.","The last day of the month in which you are no longer an eligible employee.","Partial hospitalization or a day program.","If your domestic partnership ends, call the BP Benefits Center immediately.","Aetnaalso has the right to examine your child as often as needed while the handicap continues at its own expense.","Provides medical services which are within the scope of his or her license or certificate.","If you are an employee of BP Products North America Inc.","To enroll in or decline medical insurance.","We will then reimburse them for the cost, less their copayment.","Sometimes, the planis the primary payor, which means that the planpays benefits before Medicarepays benefits.","Pocket Maximums include HRA, Deductible, and Coinsurance.","The event must be an official, sanctioned event.","It requires us to distribute a Notice of Privacy Practices to plan sponsors and subscribers of our fully insured benefits plans.","These plans provide coverage for you, your spouse or partner and your dependent children.","What do the new laws and closures mean for your business?","The last day of the month in which your covered dependent is no longer eligible for coverage under the Medical Program, whether or not you report your dependents change in eligibility status.","The information listed on this page is for employees working in the United States.","Gaiam yoga and wellness products.","Aetnawill review and process the request for an extended stay.","If any individual loses any rights or coverage under the BP Corporation North America Inc.","Unused dollars, up to a maximum, will roll over for future use.","Visit the health care provider.","Sign up for your Healthy Savings card anytime.","After that, you pay only the applicable copay or coinsurance.","The replacement of the entire base of a denture without changing the teeth.","You may also have a right of access to such files, except information that relates to a claim or a civil or criminal proceeding, and to ask for correction, amendment or deletion of personal information.","No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA.","See the Aetna Requires Proof of Other Income section for more information.","During enrollment, you will make choices for medical, dental and vision insurance, health care and dependent care flexible spending accounts, life insurance, and much more.","It is currently providing data to other Web Parts, and these connections will be deleted if this Web Part is closed.","Coverage begins after seven calendar days of disability and is taxable.","When these rights run out, other drug companies can make and sell generic versions of the drug.","If you enroll in a Medicare HMO option available to you under the BP Retiree Medical Plan, you may pay a higher percentage of the cost than if you enroll in any other medical option.","Refer to the What the Plan Coverssection and the Schedule of Benefitsfor tplan limits and maximums.","Surgery needed to improve a significant functional impairment of a body part.","Benefits may be modified during the term of this plan as specifically provided under the terms of the Group Insurance Policy or upon renewal.","Be sure to register as a new user the first time you access the new portal.","Employer match eligibility varies.","In this case only one Elimination Period will apply.","This plan will also not pay any benefits for any disability that starts after coverage ends.","Such action will not preclude the company from taking other appropriate action.","Several states have requirements for continuation of coverage that does not begin until COBRA coverage ends.","It can sometimes be difficult to determine when urgent situations are true emergencies.","If you contribute money to an FSA, you lower your taxable income, which reduces your federal income and Social Security taxes.","However, depending on how your employer completes this form, you might need to take additional steps.","If eligible dependents do not sign up at open enrollment or when they become eligible, they must wait until the next open enrollment period.","Live Well Rewards while taking actions to improve your health.","It is conducted by interviewing the worker and supervisor or observing the work place and the job being performed.","If any of the following circumstances exist, you may qualify for transition coverage: Patient is confined to an inpatient facility.","When it is necessary to group threedigit zip codes, the grouping never crosses state lines.","There are two ways to access the BP Benefits Center: When you enroll, you can elect coverage for yourself and your eligible dependents.","Employees have a choice of multiple plans.","If you have questions concerning a QMCSO or would like a copy of the applicable QMCSO procedures free of charge, contact the BP Benefits s Qualified Order Team.","If you use your HSA for expenses other than eligible health care expenses, you automatically subject yourself to IRS penalties.","We are not responsible for the data collection and use practices of such other sites.","For coverage levels other than individual coverage, all eligible family members contribute toward the family deductible.","If precertification is: then the expenses are: requested and approved by Aetna.","Establishes policies about how hospice careis provided.","The maximum length of time for which benefits will be paid.","FMLA leave, the dependent will be eligible for the continued coverage on the same terms as would be applicable if you were actively at work, not on an approved FMLA leave.","For complete details on your benefits, please refer to My Profile.","Learning is a Journey.","You can only choose the last day of a month as a termination date.","Indicates that the entire cost of a group insurance plan is the responsibility of the employee, with no contributions by the employer.","The participant shall provide all information requested by the plan, the claims administrator or its representative including, but not limited to, completing and submitting any applications or other forms or statements as the plan may reasonably request.","Inpatient personal services such as television rental and guest meals.","Manage my business policy, bills and claims, get certificates and submit audits.","Has at least one certified anesthesiologist at the site when surgery requiring general or spinal anesthesia is performed and during the recovery period.","Please purchase a SHRM membership before saving bookmarks.","The participant acknowledges that this plans recovery rights are a first priority claim against all potentially responsible parties and are to be paid to the plan before any other claim for the participants damages.","When the RRA is depleted, a surviving spouse will no longer be eligible for reimbursement of any qualifying expenses.","Your coverage includes eye examinations, prescription eyewear and contact lenses through a provider network that includes both ophthalmologists and optometrists.","Benefits for home health care visits are payable up to the Home Health Care Maximum.","You were eligible, but not enrolled, for any comparable disability coverage sponsored by your employer on the day before the effective date of this plan.","Automatically reload the page if a deprecation caused an automatic downgrade, ensure visitors get the best possible experience.","This means that the dollar amount you pay for your share of covered expenses is generally lower when you use a network provider.","Plan attorneys provide a wide range of legal services, covering most personal legal needs.","HMOs and third party administrators; underwriting activities; and due diligence activities in connection with the purchase or sale of some or all of our business.","If you call to precertify, but the claims administrator determines that your admission, proposed treatment or expense is not medically necessary: No benefits will be paid.","Savings options of the BP Medical Plan.","Ability to assess and recognize withdrawal complications that threaten life or bodily functions and to obtain needed services either on site or externally.","Employer determines your approved FMLA leave is terminated or the date of the event for which the continuation is available.","Prescription drug expenses do apply to the medical plan deductible.","Aetna remains focused on implementing provisions of the ACA, fostering and sustaining compliance with the law, and helping our customers achieve the same.","Any other single organ transplant, unless otherwise excluded under the plan.","You can also request that your personal information is provided to you in a commonly used electronic format so that you can share it with other organizations.","This is only covered when notdone in connection with the removal, replacement or repair of teeth.","We cannot accept plan changes submitted after the date listed in the letter.","Savings Options for the remainder of the plan year without earning wellness points.","Life can be tough sometimes, and nobody knows what lies ahead.","You may also detach the refill slip, complete the patient order form and mail the request to ESI with the correct payment.","The Employerselects the products and benefit levels under the Aetnamedical benefits plan.","You will be responsible for deductiblespayment percentage, ancopayment, if any.","Examples of medical emergencies include heart attack, stroke, severe bleeding, serious burns and poisoning.","Upload your own documents or access the thousands in our library.","Certificate is part of the Group Insurance Policy between Aetna Life Insurance Company and the Policyholder.","If you do not have enough money in your HSA to pay for an eligible medical expense, youll need to pay for the expense by some other means.","That way, they will be able to make the precertification call for you in case you cannot.","Blood and the administration of blood and blood products when it is for the sole purpose of enhancing ones physical status or when related to sports activities.","Aetna aims to offer more efficient and effective patient care at a more affordable cost.","Allows you to save money on a tax deferred basis.","Other income benefits can affect the weekly benefit described in the short term disability coverage section.","The number of couples enrolled in the plan.","You may not be able to access certain secure sites and member pages on the Aetna International website unless you have previously registered for them or hold applicable policies.","When a planprovides benefits in the form of services, the reasonable cash value of each service rendered shalldeemed anallowable expenseand a benefit paid.","You may also request that Aetna provide you, free of charge, copies of all documents, records and other information relevant to the claim.","Not guarantee renewal under selected conditions described in the policy.","In addition, no one may be covered as a dependent of more than one employee, unless state law requires it.","If you leave BP, any remaining money in your HSA account is still yours.","If you are rehired within the same plan year, your previous BP Medical Program coverage will be reinstated to the options in which you were enrolled before you left.","The highest benefit amount payable under the plan design.","Not eligible to be claimed as a dependent on another persons tax return.","Has a written agreement with a hospitalin the area for emergency transfer of a patient or a child.","California Civil Code, our customers who are California residents have the right to request certain information regarding our disclosure of personal information to third parties for their direct marketing purposes.","Your RRA cannot be used to reimburse you for your deductible.","Evidence of insurability for continuation of coverage cannot be required.","If the procedure requires that claim forms be submitted, you may obtain them from your employer or Aetna.","The reversal of voluntary sterilization procedures, includingany related followup care.","If eligible, you will receive an annual in your RRA based on your age and years of service, with the term meaning the plan year.","The least benefit amount payable under a disability period regardless of income from other sources.","The NAP Program is a discount program and does not guarantee precertification.","You or your authorized representative may appeal urgent care claim denials either orally, in writing or via the Aetna website.","You never forfeit your contributions to the HSA.","Wigs, if hair loss is due to certain medical conditions.","All services are subject to the exclusions and limitations described in the plan documents.","If the Planincludes medical, prescription drug, dental, vision and hearing coverage, those coverages will be considered separate plans.","OF CONTENTSCovered expenses under this Preventive Care benefit would not include charges for a voluntary sterilization procedure to the extent that the procedure was not billed separately by the provider or because it was not the primary purpose of a confinement.","Allows an insurer to deduct an amount from the life insurance benefit and pay it to a beneficiary, friend or relative before the final settlement of the claim.","OF PROVIDERIf your Aetna plan generally requires or allows the designation of a primary care provider, you have the right to designate any primary care provider who participates in ournetwork and who is available to accept you or your family members.","All forms are printable and downloadable.","You may also use your card at some discount and grocery stores, as long as they have a system that can process a health care card.","Covered as a BP employee or retiree in a BPsponsored medical plan.","Call staff can also help you find nearby urgent care or emergency care facilities.","Services that are billed separately but are identified by the claims administrator as an integral part of care or evaluation of a patient for which there is an overall reimbursable charge.","Basic term life insurance is provided to you at no cost.","Do not send any other request or correspondence with premium payments.","Consult your broker or Aetna service representative.","Fairview employees can take advantage of the Fairview Wellbeing Dollar Allowance Program, regardless of your enrollment in a Fairview medical plan.","Any change you make must be consistent with your qualifying event.","When to Enroll When Your Coverage Begins Throughout this section you will find information on who can be covered under the plan, how to enroll and what to do when there is a change in your life that affects coverage.","If you or your dependents have remaining benefits, you are eligible to convert.","Necessary services and supplies that are covered under the plan.","However, if you are intending to receive an innetwork level of benefits, it is your responsibility to confirm that each provider or facility you use is in the Aetna Choice POS II network.","Conditions that are related to pregnancy may be covered under this plan.","Your dependent is not able to engage in most normal activities of a healthy person of the same age and gender.","Coverage under any extension of benefits provision becomes effective only after any other continuation of coverage period, if elected, ends.","Examples are health plan premiums, deductibles, coinsurance and copays.","You also must include a copy of the notice and all other pertinent information that supports your request.","Members may download one copy of our sample forms and templates for your personal use within your organization.","Durable medical and surgical equipmentdoes not include equipment such as whirlpools, portable whirlpool pumps, sauna baths, massage devices, over bed tables, elevators, communication aids, vision aids and telephone alert systems.","This is a condition existing at or dating from birth.","Right of Continuation Notice to all qualified beneficiaries.","Refer to the Schedule of Benefitsfor details about cost sharing and benefit maximums that apply to Family Planning Services Other.","You, your physician, or the facility will need to call Aetnahe number on your ID card as soon as reasonably possible, but no later than the final authorized day.","Search autocomplete is currently not responding.","You also must include a copy of the final claim denial letter and all other pertinent information that supports your request.","Be the first to know about new CVS Health jobs!","Through this process, eligibility and determination of coverage can be confirmed and communicated before a member receives treatment or services.","These may include length of employment with the plan sponsor, job status and other provisions.","Health is committed to providing a solid foundation of total rewards including competitive salary, health, wellness and financial security benefits for employees and their families.","It is your responsibility to enroll or apply for benefits from other sources when you are eligible.","The specific dollar amount or percentage that the member must pay, or that must be paid on behalf of a member, when covered services are provided.","Health Care Reimbursement Account.","For Gaiam products, log in to cigna.","COB rules prevent a duplication or double payment of a providers charges for services.","Keep in mind that you can only use your debit card up to the amount already in your HSA, even though you expect to contribute more in the future.","Update it below and resend.","LTD benefits pick up where STD leaves off.","Referral to ERO The Claims Administrator will assign an ERO accredited as required under federal law, to conduct the External Review.","This PPO plan provides access to covered benefits through a broad network of health care providers and facilities.","Get the information you need to make smart financial decisions.","Who is a covered family member under the FMLA?","For a list of providers go to www.","Refer to your Schedule of Benefitssection for information on what covered expensesdo not apply to the maximum outpocket limitand for the specific maximum outpocket limitamounts that apply to your plan.","HRA is exhausted and your deductible is met.","You may receive these medications through Accredo Pharmacy, a special mail order pharmacy affiliated with ESI that is designed to service your unique needs and deliver your medication to your doorstep.","Physician Services nefits in the previous section.","Determination that has been upheld by the appropriate claims administrator, which is a named fiduciary of the Medical Plan, at the completion of the internal appeals process, or an Adverse Benefit Determination for which the internal appeals process has been exhausted.","Many events in your work or personal life can impact your benefits.","Certificate for details as to which other income benefits may reduce your weekly benefit.","Cessation of the handicap.","Medical social services, when provided in conjunction with skilled nursing care, by a qualified social worker.","Fill has a huge library of thousands of forms all set up to be filled in easily and signed.","The list of services requiring precertificationfollows on the next page.","Serve as a constructive trustee for the benefits of this plan over any settlement or recovery funds received as a result of Third Party Injuries.","Are you doing all you can to stay healthy?","Participating in the challenge is easier than ever.","Note that we may request to verify your identification before fulfilling your request.","Your points determine the amount of your annual credit.","Summary Plan Description required by ERISA.","How Coordination of Benefits Works.","If you live in one of the following States, you may be eligible for assistance with paying your employer health plan premiums.","COBRA coverage period: You and your spouse divorce or your domestic partnership or civil union ends.","Except for emergency services, Aetnawill only pay up to therecognizedcharge.","Therapies and tests, including but not limited to: Full body CT scans; Hair analysis; Hypnosis and hypnotherapy; Massage therapy, except when used as a physical therapy modality; and Sensory or auditory integration therapy.","You do not have to enroll in a BP medical option to be eligible for EAP services.","Unused money will carry over from one year to the next, helping you save for future expenses.","The date BP terminates the Medical Program.","Bacteria grow in dental plaque, which sticks to the tooth or root surface next to the gums, causing swelling.","Click here to view important documents.","You may not be able to control life, but you can take steps to protect yourself.","Submit claims, check status of disability or leave, and see payments.","Outpatient interventional pain management.","The BP Care website also provides quick links to the following tools in the right navigation, click on: Locate Resources to find help in your area, for example, to locate available day care, schools and volunteer opportunities.","According to current regulations, the expense must be primarily to alleviate or prevent a physical or mental defect or illness.","Exhaustion of internal appeals process You are required to complete all appeal processes of the Medical Plan before being able to obtain External Review or bring an action in litigation.","The dollar amount you enter is the annual amount.","This includes day care and night care treatment.","Find a Provider tool.","View your coverage details.","The plan will pay for covered expenses, up to the maximums shown in the What the Plan Covers Schedule of Benefitssections.","Short Term Disability Any lump sum or periodic payments you receive from any other income benefit are prorated on a weekly basis over the period of time for which the payment was made.","RRA is depleted, a surviving spouse will no longer be eligible for reimbursement of any qualifying expenses.","Medicare benefits even if that event does not trigger loss of group If you have HMO coverage, state law may provide for an additional period of coverage beyond the COBRA Continuation periods.","If you select the Health Savers Plan, you will be required to pay the full amount of your prescription drug costs until you meet your deductible.","Calendar Year of the accidentor in the next Calendar Year.","Refer to the What the Plan Coverssection of the Bookletfor more information about your coverage.","That is measured solely from the date of the qualifying event or, if the plan provides, from the date of the loss of coverage.","Important Notice: You must pay the required contribution in full.","Aetna unless your statement was in writing on a form signed by you and was fraudulently made in order to obtain that coverage or increase.","In processing your claim incurred while traveling abroad, ESI uses the conversion rate posted on as of the date the prescription was filled.","Coverage under this plan is nonoccupational.","This applies only to the amount of the benefit that was paid by an employer.","Attention Oklahoma Residents: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.","Please enable scripts and reload this page.","Stay tuned for information on this program and how to participate.","This coverage will be provided in consultation with the attending physician and the patient, and will be provided in accordance with the plan design, limitations, copays, deductibles, andreferral requirements, if any, as outlined in your plan documents.","Savings option, although you are not required to complete the physician certification form, only employees who do so will receive the BP contribution to their Health Savings Account.","Any form of health plan in which members have access to a network of contracted health care professionals and hospitals, and that requires approval of some services.","COBRA continuation after their termination.","This can mean financial hardship for you and your family.","Retroactivity and other adjustments: Charges for activity that has not been billed before, or adjustments to amounts billed earlier.","If you had already satisfied the probationary period before you entered the eligible class, your eligibility date is the date you enter the eligible class.","Workers Compensation, or benefit time.","Care management includes condition management and complex case management, and is coordinated through plan providers.","In future years, you will enroll during Open Enrollment.","Refer to the Schedule of Benefitsfor details about the maximums that apply to infertilityservices.","Participating doctors and hospitals agree not to bill the member for the difference between these two amounts.","The last day of the month in which the covered person becomes covered under another group health plan during the COBRA coverage period, unless that plan contains an enforceable clause for preexisting health conditions.","Since the BP Medical Plan provides medical and surgical benefits for mastectomies, it must also provide coverage for: Reconstruction of the breast on which the mastectomy was performed.","Discounts offered hereunder are not insurance.","The following rules determine which plan is primary: A plan that does not coordinate benefits is the primary plan and determines its benefits first.","Please try again later.","These include: For the PPO Options, eligible expenses provided by providers who are not Choice POS II network providers but who are Aetna NAP For the OOA Options, eligible expenses provided by a provider who is an Aetna NAP provider.","Each IOE facility has been selected to perform only certain types of transplants.","This means that Fairview will work directly with the learning institution to pay before you start class.","COBRA continuation, please retain the original copy of the election form on file.","Cardiac rhythm implantable devices.","Cost Sharing amounts and provisions are described in the Schedule of Benefitsnetwork providershave not agreed to accept the negotiated charge.","Savings OOA Option has two separate outpocket maximum amounts.","Drugs that do not require a prescription, even if prescribed by a doctor.","An enrollment form is required as well as appropriate eligibility forms.","The expenses that apply to the outpocket maximum vary depending on the option in which you are enrolled.","Your Aetna representative can give you more information on what your plan requires.","Only devicetracked steps will count toward the Million Step goals.","Family coverage, even if only one family member incurs medical expenses during the year.","The amount you owe for health services before your health insurance begins to pay.","Cannot be reasonably left out or changed.","Scholarship Program offers tuition assistance to dependents of Niagara Team Members who are continuing their education in college or vocational school programs.","This can be done if the benefit is payable to you and you are a minor or not able to give a valid release.","On active duty in the military.","Financial or legal counseling.","ALL of your enrolled dependents are NOT eligible for Medicare.","You do not need approval from your manager to take Parental Leave.","However, coverage for health expenses may be available to you under another plan sponsored by your Employer.","Transgender reassignment surgery, when deemed medically necessary and subject to satisfying specific criteria established by the claims administrator depending on the type of reassignment.","However, an eligible employee or dependent may not be considered a Late Enrolleeunder certain circumstances.","Signed by the employee as well as spouse or partner.","This includes intravenous feeding and enteral nutrition, which is the delivery of nutrients into the stomach by tube.","There was a problem sending your message.","Your health plan is always secondary to automobile nofault coverage, personal injury protection coverage, or medical payments coverage.","Note: Prescription, dental and certain other plans and benefits cannot be converted to individual plans.","Covered expensesalso include instruction and incidental supplies needed to use a covered prosthetic device.","Annuities and insurance products are provided by various insurance companies and offered through Chase Insurance Agency, Inc.","This smoothing of the root surface is performed to help remove the uneven surface that would allow bacteria to attach easily.","Aetna and Anthem negotiate.","This will be done at all reasonable times while certification or a claim for benefits is pending or under review.","This form will authorize your health care provider to release your medical information to CSS.","Vea lo que est\u00e1 disponible ahora.","NAP ancillary providers include: Acute rehabilitation facilities.","Also included is any other mental condition which requires Medically Necessary treatment.","The last day of the month in which you die.","If so, provide a copy of the court order.","Each PPO Option has separate network and outnetwork medical coverage plan year deductibles.","It will indicate any amounts you owe towards your deductiblepayment percentage, or other noncovered expenses you have incurred.","Together we are helping people on their path to better health.","ESI online or via phone.","Retirement Plan section for more information.","Your doctor should submit a request for clinical review for the following services: Cardiac imaging, including nonurgent outpatient diagnostic catheterization and echo stress tests.","Specific conditions or circumstances that are not covered for benefits under a plan.","BP Retiree Medical Plan eligibility at the time you left the nonparticipating employer, you will become eligible for access to retiree medical coverage based on your age and your total vesting service in a BP retirement plan.","Brand name drugs include preferred drugs and nonpreferred drugs.","So it is very important that you keep your receipts as your reimbursements could be subject to a review by the IRS.","Office visit copays, urgent care facility copays and prescription drug expenses do not apply to the plan year deductible; however, they do apply to the plan year outpocket maximum.","The office visit copay includes: The doctor office visit.","You must then describe the type of care you need to provide and the amount of time you need off to provide that care.","Parttime or intermittent home health aide services to care for you up to eight hours a day.","The vaccine is FREE to Medicare Advantage members.","Note: The FMLA also allows leave for an eligible employee to care for a covered servicemember with a serious injury or illness.","Participate in wellbeing challenges to help build healthy habits to move more, eat well, stress less and sleep better.","Your networkproviderwill take care of claim submission.","It is important to understand that the same rules of the Internal Revenue Code for controlling employers apply to COBRA.","Services and supplies furnished on an outpatient basis.","Enter the telephone number of the person who is administering the COBRA continuation.","Money in your account after April plan carefully.","Home health aide services, when provided in conjunction with skilled nursing care, that directly support the care.","The Elimination Periods and the maximum weekly benefit period are shown in the Schedule of Benefits.","Vision Statement: To become the premier employee benefits department providing competitive benefits utilizing innovative resources to make our customers better consumers of related benefits services.","If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.","This is performed in rare instances when the patient has not had a dental cleaning in a very long time and a gross amount of debris has built up.","Review our privacy policy.","Although leaving BP will end your eligibility for coverage, you do not need to take action to notify the BP Benefits Center.","Medicare program after the date of their COBRA election.","To control cookies, most browsers allow you to either accept or reject all cookies, only accept certain types of cookies, or prompt you every time a site wishes to save a cookie.","Home Office is Hartford, CT.","The RRA can be used for any qualified medical expense.","Let SHRM Education guide your way.","Your spouse cannot be seeking a degree at Vanderbilt.","The employee need not be the only individual or family member available to care for the qualifying family member.","Amniocentesis, ultrasound or any other procedures requested solely to determine the gender of a fetus, unless medically necessary to determine the existence of a genderlinked genetic disorder.","This will be the date you stop active work.","Dedicated retirement planners can help you learn about investment funds, discuss how much money you may need at retirement, review your current investments, learn how to initiate a rollover, or discuss investment strategies.","Whether you see a network provider or an outnetwork provider, each PPO Option covers a broad range of medical services and supplies once you meet your deductible, as well as preventive care services that dont require you to meet your deductible.","The following will be considered to be one transplant occurrence once it has been determined that you or one of your dependents may require an organ transplant.","Your claim must give proof of the nature and extent of the loss.","It can also involve restructuring job duties.","If your Aetna planallows for the designation of a primary care provider for a child, you may designate a pediatrician as the primary care provider.","What is Patient Care Advocate?","However, services associated with foot care for diabetes and peripheral vascular disease are covered when medically necessary.","Any adaptive equipment or devices designed to suit your identified medical limitations; that would allow you to perform your own occupation.","Certificate in the absence of payment of current premiums subject to the Grace Period and the Premium section of the Group Insurance Policy.","Any alikedisorder in the relationship the jaw joint and the related muscles and nerves.","If the last filing date would fall on a Saturday, Sunday or federal holiday, the last filing date is extended to the next day that is not a Saturday, Sunday or federal holiday.","Track SSO link clicks.","To be sure that claims payments are not interrupted, be sure to mail your payment by the due date listed on your payment stub.","Accident Insurance from The Hartford complements other benefits, including traditional healthcare insurance.","Then this continuation coverage will end on the date the plan ends.","In Maryland, by Aetna Health Inc.","You request to reinstate coverage that ended because you voluntarily stopped your coverage or you did not make the required contributions.","Short Term Disability Benefits will be paid weekly.","If you transferred to a nonparticipating group and wish to retire under the above provisions, you need to coordinate with HR and BP Benefits to request retiree medical coverage.","Get access to exclusive LA Fitness Membership pricing with Niagara.","An annual deductible is required before this plan pays benefits; this plan uses a narrow network of providers.","Information is believed to be accurate as of the production date; however, it is subject to change.","Hospitalization due to a medical emergency.","Voluntary: any contribution above the mandatory level.","The law requires these plans to continue offering coverage to individuals who would otherwise lose it.","Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office, dial KIDS NOW or go to to find out how to apply.","Copays for specialty medications Copays for certain specialty medications will vary depending on the amount of available assistance provided by manufacturers of the particular medication.","If your group plan allows retirees to continue medical coverage, and you wish to continue your plan, then the conversion privilege will not be available to you again.","Department manager approval is required.","In order to qualify for Aetnas contracted NAP rates, the expense must be covered under the plan and the provider must submit the charge to process at the contracted amount before you pay for services.","Geographic Area where the service is furnished.","You can participate at the voluntary level prior to being automatically enrolled at the mandatory level.","Services provided in conjunction with school, vocation, work or recreational activities; Transportation; and Wilderness treatment programs.","How the PPO Options work The PPO Options are networkbased options that utilize the Aetna Choice POS II network.","You can use these funds to meet your deductible.","What else you should know about HMOs HMOs are independent business entities.","If there is a discrepancy between this information and the plan or policy documents, the plan or policy documents will govern in all cases.","HMOs network for yourself and for each family member you cover.","You will not be considered to be disabled, and no benefits will be payable.","Evidence of Coverage booklet at hr.","Treatment for physical complications at all stages of the mastectomy, including lymphedema.","Aetna Life Insurance Company.","You do not need prior authorization for the treatment of an emergency medical condition.","If the natural parent without custody has legal financial responsibility for the childs medical care, the plan of that parent becomes the primary plan.","As there is not yet a common understanding on how to interpret the DNT signal, we currently do not respond to DNT signals on our site.","Break out early, do not processing if a downgrade reqeust was already sent.","The effective date of COBRA.","These cookies stay on your computer or device after your browser has been closed and last for a time specified in the cookie.","The routine care, testing, checkups and shots for a generally healthy child from birth through the age of eight.","You do not make any contributions to your RRA, and it accrues no interest.","Store this Booklet in a safe place for future reference.","Switzerland in reliance on the applicable Privacy Shield Framework or that they have been subjected to strict contractual provisions in their contract with us to guarantee an adequate level of data protection for your data.","The plan administrator has designated the various claims administrators to manage the dayday operations of the plans, including processing and paying all claims for benefits.","BP retirement plan, then that service will be taken into account when calculating the applicable RRA annual credit for your most recent rehire period.","Enter the address to which the qualified beneficiary must return the application and premium payments.","The last day of the month in which you drop coverage due to a qualifying status change.","What you pay each pay period for medical insurance depends on how many people you cover, which plan you choose, and your tobacco status.","Meets any licensing or certification standards established by the jurisdiction where it is located.","Aetna group plan is summarized here.","This determination will be conclusive and binding upon all persons for the purposes of this lan.","You will need to access the link either at a Niagara location or via VPN.","Written procedures for such a transfer must be displayed and the staff must be aware ofthem.","Joining our talent community allows us to send you company news, industry updates, and new job opportunities.","The member must pay these before any expenses are paid under the plan.","Health offers salaries that are competitive with the external labor market.","If there are no such rooms, Aetnawill figure the rate based on the rate most commonly charged by similar institutions in the same geographic area.","The language on this page is not intended to create, nor can it be construed to create, a contract between Fairview and its employees.","Amalgams are silver in color and usually used on posterior, or back, teeth.","Request a Quote Today!","Aetna sites are provided for your convenience only.","Aetna, the Company and the Plan will abide by the decision of the External Review Organization, except where Aetna can show conflict of interest, bias or fraud.","You can use your card to pay for health care products and services, including doctor and dentist visits, hospital stays, prescriptions and hearing and vision care.","The processes for controlling and deleting cookies vary depending on which browser you use.","Fairview in the future.","Term Disability Benefits are here to take care of you.","You do not need prior authorization for the treatment of an emergency medical condition, even if the services are provided by an outnetwork provider.","Patient is in a postoperative period.","Innetwork physicians have been engaged regarding this requirement and should be aware of the process.","Getting Started Important Terms.","Place a lien, if not prohibited by law, in the amount of the overpayment on the proceeds of any other income, whether on a periodic or lump sum basis.","Medical Plans claims and appeals procedures.","Under COB, one plan is primary and the other plan is secondary.","Therefore, the HMOs rules and procedures must be no less beneficial to HMO participants than the rules that apply to claimants under the BP Medical Plan.","Rice University offers a wide range of health and welfare benefits and several retirement options.","You should contact your State for further information on eligibility.","Increase your financial knowledge with a range of useful financial planning topics.","Is due to insurrection, rebellion, or taking part in a riot or civil commotion.","Precertification required; benefits may be reduced or denied if precertification not obtained.","Deductions will begin as soon as administratively possible.","It includes a review of past jobs and education, as well as hobbies and household activities, in order to create a list of skills that might be transferred to other types of employment.","If you need help determining whether your situation is a true emergency, you can consult a doctor who will be able to tell you what steps to take.","The counseling sessions will teach you techniques and changes in behavior to reduce the stress.","When you log in, you can track your expenses, claims and account balance, in addition to submitting claims online.","We understand thatany time away from work without pay can make it hard to keep up with yourexpenses.","You have been redirected to an Aetna International site.","Make sure your member ID number is on the bill.","Different medical practices, hospitals may charge different fees and offer a different level of service.","Not available for individual sale.","Not yet a colleague?","Need to find out what something means?","Form used when you divorce or terminate domestic partnership.","Provides, or arranges with a facility in the area for, diagnostic Xray and lab servicesfor the mother and child.","If you were not retirement eligible at the time of your initial terminiation, that balance was forfeited and you will not be eligible for the RRA.","See Preventive care Prescription drug coverage The medical plans all offer prescription drug coverage.","If you experience a qualifying event, such as marriage or the birth of a child, you may make changes to your benefits that are consistent with the event.","POA or courtappointed conservator or guardian.","All necessary information, including the appeal decision, will be communicated between you or your Authorized Representative and Aetna by telephone, facsimile, orother similar method.","Plans Compared See more details at hr.","You will not be eligible for either a subsidized premium or participation in the BP Retiree Reimbursement Account Program, as described in preceding sections.","This online digital learning will provide tips for improving your sleep and information on common sleep disorders, causes of sleepless nights, and effects of sleep deprivation.","Claims that have already been paid directly by the plan participant before the provider has submitted the claim to Aetna at the contracted rate.","Click for the rules.","Charges for activating the donor search process with national registries.","Reimbursement Accounts are available.","If you purchase any prescription medication from a nonnetwork pharmacy, submit a claim to Express Scripts, Inc.","This can be done in states that provide such rights and that grant immunity to insurers providing such access.","Qualifying status changes that require action There are some qualifying status changes that require you to make changes to your coverage.","You can even connect with a counselor via the BP Care instant messageservice.","GYN services at St.","With the exception of Aetna Rx Home Delivery service, all participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna.","Contributions made by your Employer to any deferred compensation arrangement or pension plan.","The plan also provides coverage for certain preventive and wellness benefits.","The severity of your disability changes.","Need to an individual who is no longer an eligible dependent due to: Legal divorce or annulment.","CVS Health job opportunities.","Your paymentpercentagewill be based on the recognizedcharge.","One of the BP employers who do not offer coverage in the BP Retiree Reimbursement Account Program is BP GBS Americas.","Life and Disability benefits and insurance plans contain exclusions and limitations.","This may require a mode change.","These maximums are exclusive of each other.","If the volume of charges in a single three digit zip code is sufficient to produce a statistically valid sample, an expense area is made up of a single three digit zip code.","The Office of Human Resources will be closed for winter recess starting Monday, Dec.","They are subject to the same deductibles and coinsurance limitations as other services.","These features, when turned on, send a signal that you prefer that the website you are visiting not collect and use data regarding your online searching and browsing activities.","For more information on Google Analytics cookies, visit www.","Helps eligible members get covered treatment for solid organ transplants, bone marrow transplants, and some other rare or complicated conditions at participating facilities experienced in performing these services.","If you are subsequently rehired as a BP employee, your Retiree Medical Plan coverage will end.","The participant shall do nothing to prejudice the plans recovery rights as herein set forth.","We join the right medical professionals with the right technology, so patients benefit from quality, personalized health care designed to help them reach their health ambitions.","Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service.","Cancel at any time.","You pay for services and file a claim with ESI.","If you have reached your lifetime maximum, you will not be able to convert.","BP as of the time of your retirement.","If estimating your other income benefits results in an underpayment, Aetna will pay you the difference between the underpayment and the benefit payable.","In the absence of a court decree, it is the parent with whom the child resides more than one half of the calendar year without regard to any temporary visitation.","As the employer, you can decide whether you will allow coverage to continue up to the limits stated in your plan documents or whether you will continue coverage at all.","Qualifying events You may elect COBRA coverage if your coverage would otherwise end because: Your work hours are reduced and you are no longer eligible for that coverage; or You leave BP.","HIPAA rules also improve the efficiency of the health care system, by: providing a standard way to electronically send health information and; protecting the security and privacy of information that can identify a member.","Parental Leave in your next available paycheck along with your regular base pay.","However, we recognize that many members do not want to receive unsolicited marketing materials unrelated to their health, disability and life benefits.","You can also earn Live Well Rewards for participating.","Services received for an unexpected illness or injury that is not life threatening but requires immediate outpatient medical care.","Habilitation therapy services have to follow a specific treatment plan ordered by your physician.","You could have been covered for years, but the certificate will not show all of your coverage history.","For more information about this qualifying event, contact your legal counsel.","Member Services Unit at the tollfree phone number on your ID card.","For example, attaining the maximum age of coverage.","In some instances, you may also have a third plan, which is known as tertiary.","Are considered a small employer under COBRA.","The application packets below are provided for informational purposes only.","The rights or benefits under this plan may not be assigned by a participant or beneficiary.","Typically, a pharmacist at the home delivery program facility will fill your prescription with a generic drug, if available, unless your doctor specifies otherwise.","ALEX uses information you provide to help you make choices tailored to your needs and the needs of your family.","The formulary applies to medications that are dispensed in a retail pharmacy or mail service setting.","Planprovides coverage for a private room.","Will continue for a specified period of time or until the occurrence of a specified event, such as the return to work of a regular employee or the completion of a special assignment or project.","Coverage is not automatic.","Treatment of illness or disease done by bringing dry or moist gases into the lungs.","You may then submit your claimto Medicarefor consideration.","Eff date: The effective date of the transaction.","Coverage for Short Term Disability Benefits If your short term disability coverage ends during a period of disability which began while you were covered, any short term disability benefits will be continued until your benefit eligibility ends.","Aetnaknow when your employment ends.","The operators of such other websites may collect information about you, including through cookies or other technologies.","Savings Option during a calendar year, this could have a retroactive effect on the taxfree nature of some of your HSA contributions either made by BP or you.","Even if you rely on someone else to make the call for you, it is your responsibility to follow up to be sure the call was made.","An injury is not the direct result of illness.","In most cases, chemotherapy is covered as outpatient care.","Refer to Short Term Rehabilitation Therapies section for coverage information.","While your domestic partner is not eligible for survivor coverage under the BP Retiree Medical Plan, your domestic partner can elect continuation coverage under the BP Medical Program.","Coverage levels depend on where treatment is received.","You will not accrue additional RRA credits while employed at the nonparticipating employer.","Compatibility testing of prospective organ donors who are immediate family members.","Your account number: You should put this on all correspondence and forms.","If the misstatement affects the existence or amount of coverage, the true facts will be used in determining whether coverage is or remains in force and its amount.","Treatment in wilderness programs or other similar programs.","Aetna uses a commercial software package to administer some of these policies.","Defined terms appear in bolded print.","However, you will be able to file reimbursement claims of covered expenses incurred before the programs termination date.","The charges must be regularly made at a daily or weekly rate.","You will become eligible for BP retiree medical coverage if you satisfy the retiree medical requirements of the BP business unit in which you work via a combination of age and service.","Work with you to help resolve claim inquiries or billing issues.","Electing COBRA coverage The COBRA election process is a threestep process: You or your covered dependent must experience a qualifying event that triggers COBRA eligibility.","You are now being redirected to www.","How to use your RRA When you have a qualified medical expense: Pay the expense.","Members who have not yet received their ID cards may still have their prescriptions filled at a participating pharmacy.","Where you have consented to our use of your personal information, you can withdraw your consent at any time.","It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan.","Claims, Appeals and External Review.","The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a preapproved treatment plan, or procedures for making referrals.","Plan changes must be submitted to us within the specified time frame on your renewal proposal.","Send to someone else to fill in and sign.","If there was no matching functions, do not try to downgrade.","Final Internal Adverse Benefit Determination is provided, to give you a reasonable opportunity to respond prior to that date.","Learn more about local resources, food banks and assistance for those who may need it.","Note that civil union ceremonies are specifically not permitted to be treated as marriages under federal law.","Your claim will not be processed until you comply with the claims administrators request.","The Advocacy Service is available to help you with issues regarding health care claims and services.","Plan or any other prior coverage.","Bill package: The number assigned at plan setup.","The claim denial letter you receive from Aetna will describe the process tofollow if you wish to pursue an external review, including a copy of the Request for External Review Form.","An employee does not need to use this leave entitlement in one block.","Vanderbilt Eye Institute, Target, Walmart and Lens Crafters.","Aetna is a top carrier in the Medicare space and offers a strong provider network.","Increase the number of hours you work, or the number or type of duties you perform for another employer after the date of your disability started.","This means Aetnawill reduce the amount paid towards your coverage, or your expenses may not be covered.","For members who have medical and disability coverage, refers to the service that combines focused case management with individual contact.","NIAGARA WATER permits INSURERS to offer employees of NIAGARA WATER certain voluntary insurance programs.","If youre successful, the court may order the person you have sued to pay these costs and fees.","PCP can be a general or family care doctor, an internist or pediatrician.","The plan covers charges for oneroutine eye exam in a Calendar Year.","Multiple exams, evaluations and functional capacity exams may be required during your disability for an ongoing claim.","Enroll your employees with the online enrollment tool.","Once finished you can manually add any additional fields and signatures to the document by dragging them from the toolbar.","You may need to pay the full amount and submit a claim for reimbursement to Aetna.","The date you reach the end of your maximum benefit period, as shown in the Schedule of Benefits.","You can see the list on the Navitus member website at www.","FMLA provides unpaid leave that guarantees your job.","The number of families enrolled in the plan.","Some benefits are subject to limitations or visit maximums.","You can use your debit card for health care bills that have a Patient Balance Dueif your account is active, you incurred the expense in the current plan year and you have enough funds in your account.","Accredo for the applicable home delivery copay or coinsurance.","Caps Lock is on.","The language in the insurance contracts and documents will prevail should there be a conflict of information.","This is defined as the probationary period.","This includes only a grandchild related to you by blood, marriage or domestic partnership whose parents do not live with the child and for whose daily care and guidance you are legally responsible.","You will receive notification of what the plan has paid toward your medical expenses.","Outpatient detoxification must be precertified by calling the claims administrator at the tollprecertification number shown on your medical option ID card.","You will not be eligible for either a subsidized premium or participation in the BP Retiree Reimbursement Account Program, as described in preceding programs.","Results from your commission of, or attempting to commit a criminal act.","It is important to complete a metabolic screening to learn your numbers, identify your risks, and plan positive lifestyle changes that will help you maintain or improve your results.","Exclusions and limitations apply to certain medical services, supplies and expenses.","Also, make sure that your health care insurance will cover the costs of your prescription drugs.","Here are some ways to save money on the medications you take.","BP retirement plan as of your original termination date; then you are eligible for the subsidized premium upon meeting the BP Retiree Medical Plan eligibility rules and are not eligible for the RRA.","Filing your new claim should take about fifteen If someone else makes the call on your behalf, he or she will need to provide this information.","The period an employee must continuously be absent from work, because of disease or injury, in order to be eligible for extended life insurance.","The maximum outpocket limitapplies to both network and outnetwork outofpocket expenses.","Members can get help with HR questions via phone, chat or email.","COBRA does not require continuation of life or disability insurance coverage.","The procedures are done while not confined in a hospital or any other facility as an inpatient.","For more information, see hr.","You or your Authorized Representative may appeal urgent care claim denials either orally or in writing.","Patient is terminally ill and anticipated to have less than twelve months to live.","Refer to the chart on the right.","This change does not affect medications supplied by an emergency room, or during an inpatient hospital stay.","The date you begin an unpaid leave of absence not approved by BP.","Money not used will be lost, as required by federal law.","COBRA when they become entitled to Medicare will lose COBRA coverage, and certain retired members may lose coverage.","When you use home delivery, you must submit information to ESI.","If your Employer grants you an approved FMLA leave in accordance with FMLA, you may, during the continuance of such approved FMLA leave, continue Health Expense Benefits for you and your eligible dependents.","Savings Options in subsequent years.","The FMLA allows covered employees to take.","Health Savings Account during the remainder of that plan year.","American Psychiatric Association which is current as of the date services are rendered to you or your covered dependents.","Termination includes strikes, layoffs and walkouts.","You are also responsible for filing claim forms when you see outnetwork providers.","Do you want to continue?","Home births: Any services and supplies related to births occurring in the home or in a place not licensed to perform deliveries.","The information below is an overview.","Notify your manager or supervisor immediately, unless it is an emergency.","Lists the schools, hospitals and places of worship near you.","Welfare BP Corporation North America Inc.","This document is locked as it has been sent for signing.","Your use of direct billing does not exempt you as the employer from your obligation under COBRA.","In this section, you will find details on how and why coverage ends, and how you may still be able to continue coverage.","The request is badly formed.","Provides living arrangements that foster community living and peer interaction that are consistent with developmental needs.","Your benefits may be cancelled for nonpayment of benefit premiums.","Have your employees complete their online health assessments.","You must call the precertificationtollfree number on your ID card to precertifyservices.","Your monthly cost is calculated automatically when you enroll.","The amount charged to the policyholder when a covered member chooses to convert group policy coverage to an individual policy.","The administrators for claims and appeals will continue to observe their timelines for review and response to claims and appeals set forth in the plans.","This is your primary business location.","Aetnawill rely upon your employer to determine whether or not a person meets the definition of a dependent for coverage under this Plan.","Please answer the security question below to reset your password.","Dependents are also eligible.","You should consult a tax advisor before taking this step.","See the HSA Quick Reference Guide for tips on how to manage your account online.","This means your outpocket costs will generally be higher.","The last day of the month in which you drop the dependents coverage due to a qualifying status change.","If you do not precertify, your benefits may be reduced, or the plan may not pay any benefits.","Any changes to our Privacy Policy will become effective upon posting of the revised policy on the Website.","Additional provisions are described elsewhere in the group contract.","If you choose to reach out for help via the BP Care website, you will find a variety of information on numerous topics.","As is true of most websites, we gather certain information automatically.","This does not apply if coverage ceased because the benefit section ceased for your eligible class.","You may appeal such determinations by contacting Aetnato seek a reviewof the determination.","The date the claim is received.","This request may occur in connection with a claim you have submitted.","Experimental or Investigational Treatment.","Expenses covered under the BP Medical Plan hardening therapy or programs.","Nonsurgical treatment of infections or diseases of the mouth, jaw joints or supporting tissues.","No benefit is provided if you use a nonparticipating pharmacy when an ESI network pharmacy is available.","These are your biological parents, siblings or children.","BP provides employees and their families the opportunity to purchase quality health care at affordable rates.","Please fill out if you are making a change and bring supporting documentation if needed.","In order to determine whether a participant has engaged in improper conduct by covering an ineligible dependent, the plan administrator has the right to conduct internal or external audits of covered dependents at any time.","Through the tuition reimbursement plan, Fairview recognizes the importance of continuing education.","If your outnetwork providercharges more than the recognizedcharge, you will be responsible for any expenses above the recognizedcharge.","You may also request a booklet describing your HMOs general rules and services.","The review will be subject to the same procedures, protocols and standards.","Benefits are payable up to the hearing supply maximum listed in the Schedule of Benefits.","Certificate or under the terms of the Group Insurance Policy, the plan does not pay benefits for a disability that starts before coverage starts under this plan.","If you did not complete a Medicare Advantage Open Enrollment form, you will not lose your coverage.","This rule also applies to an increase in your coverage.","Procedures that do not require an overnight stay in the hospital or ambulatory surgery facility.","Please pay the total amount due listed on your invoice each month.","Expenses not covered by the OOA Option.","The aim has been to present a simplified overview of essential information about your benefits in words that are not obscure or likely to be misunderstood.","Special rules apply to California applicants.","This federal act ensures the privacy and security of health information.","Acupuncture in lieu of anesthesia.","Notice of Information Practices at www.","Attention Washington Residents: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company.","If you choose not to file for voluntary review, the Medical Plan will not assert that you have failed to exhaust your administrative remedies because of that choice.","We also collect other information you may voluntarily provide.","PPO Option Office visit copays.","Aetnas under the plan.","Failure to hold such funds in trust will be deemed a breach of the participants fiduciary responsibility to the plan.","The plan is entitled to recover from any and all settlements or judgments, even those designated as pain and suffering or noneconomic damages only.","If Aetna is your health care carrier, we will ask for your consent to share medical and disability claims information.","BP, depending on your age and your years of service when you left BP.","COBRA election period does not begin until the date the qualified beneficiary is notified, if later than the date of the qualifying event.","Check if I can initialize it in every loop or if i need an addtional list.","Repair of purchased equipment.","If your educational institution does not participate in Tuition Assistance, you may still be eligible for reimbursement through this program.","This includes reviews by physicians, other than those who own or direct the agency.","The determination by an insurer or health plan of the availability of health insurance or health benefits for a claim and the level of benefit to be paid.","If the Medical Plan requires you to obtain advance approval of a nonurgent service, supply or procedure before a benefit will be payable, a request for advance approval is considered a preservice claim.","Medicare Advantage Plans include Part D, and offer comparable or better pharmacy benefits.","Total retroactivity: The total of all subscriber retroactive changes.","For a full list of services, visit hr.","Aetna NAP network and does not honor the copay shown on your medical ID card, you will need to pay the full amount and submit a claim for reimbursement to Aetna.","Tuition Assistance Policy and Tuition Assistance Application.","Are you sure you want to do this?","Social Security numbers: List the SSNs of any dependents being covered.","Surgical correction of refractive errors, such as radial keratotomy or LASIK surgery.","Payment due date: Date that payment is due.","See COBRA section for more information.","Unless state regulations require a carrier to prorate, all terminations will be processed the last day of the billing cycle.","Some of this data is collected through information sent by your web browser.","Holiday pay is not available to employees on leave, including Diversity Day and your Birthday iday.","They are eligible on the day they are rehired.","Composites are white and usually used on anterior, or front, teeth.","You or your covered dependents become eligible for any other medical coverage under this plan.","Other Health Care benefits category when Aetna determines that a network provider is not available to provide the service or supply.","GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law.","The Plan limits the amount you have to pay each year for medical care.","The Hartford Financial Services Group, Inc.","Related supplies and services provided by the facility during the transplant process.","When taking a FMLA leave, the employee must have the the appropriate FMLA Form completed and returned to either Human Resources or their department.","IOEfacility only for those types of transplantsproceduresfor which it has signed a contract.","You may ask that we make corrections to any information we hold, if you believe such correction to be necessary.","You can find doctors by name, specialty and location.","Aetnawill have the right to require proof of the continuation of the handicap.","Please call the number on the back of your member ID card.","You can contact your Citi Health Concierge by calling the phone number on your medical ID card.","The Aetna Medicare Supplement Plan lets you visit any licensed doctor or hospital who accepts Medicare.","Member Services telephone number is on your Identification Card.","Which Plan Pays First.","No one can replace you.","Operating the motor vehicle while under the influence of alcohol at a level which meets or exceeds the level at which intoxication would be presumed under the laws of the state where the accident occurred.","Getting your annual physical and any recommended screenings or immunizations can help detect any issues early on and potentially prevent more serious and costly conditions from developing.","In case of loss of life, benefits may also be available for education, child care and return of remains.","If an outnetwork provider bills you directly for an amount beyond your cost share for the treatment of an emergency medical condition, you are not responsible for paying that amount.","Solely for purposes of final claims appeals under the BP Prescription Drug Program, MCMC and not ESI is the applicable claims administrator.","You can submit the form one of three ways, outlined below.","If you are receiving SDI, this percentage will be reduced.","Your coverage choices are: You only.","Your dependent no longer qualifies as an eligible dependent.","Until then, we ask for your patience and understanding.","For the PPO Options: The network level of benefits is paid for treatment received at a facility designated by the plan as an IOE for the type of transplant being performed.","These important features include preventive care, recognized charge limits, precertification requirements and more.","Military Family Leave is unpaid but employees may use benefit time.","Overview Brochure at hr.","Some of the qualifying reasons for taking FMLA leave are pregnancy, adoption, personal illness, and military leave.","Click the verification link in your email to start sending, signing and downloading documents.","To make your changes, log on to the BP Benefits Center online or call the BP Benefits Center and speak with a representative.","Provides a level of skilled intervention consistent with patient risk.","Questions about your benefits?","Others have four tiers, three tiers or two tiers.","Benefits will be paid as soon as the necessary proof to support the claim is received.","However, if you apply for and receive these benefits, they will be considered as other income benefits and you must provide proof to Aetna, if requested.","An urgent situation requires prompt medical attention to avoid problems and unnecessary or severe pain, such as a high fever.","You are responsible for the entire cost of any additional pieces of the same or similar equipment you purchase or rent for personal convenience or mobility.","These accounts can help you save money by setting aside a portion of your income to pay for eligible medical expenses or day care expenses and reducing your taxable income.","The rule which applies to a dependent to determine if total disability exists when health expense insurance ends will also apply to you.","Adverse Benefit Determination will be provided free of charge upon request by you or your Authorized Representative.","At the end of that time, you will have the choice of seeing a network provider and receiving the higher, network level of benefits or continuing to see your outnetwork provider at the lower, outnetwork level of benefits.","Disability benefits under a group life insurance plan, if the disability benefits would reduce the amount of your group life insurance.","Health Savers Plan, the employee is responsible for the full cost of prescriptions until the deductible is met.","Is technology keeping workers healthy or making them ill?","Utilized in the proper quantity, frequency and duration for the treatment of the condition for which they are ordered; and Not redundant when combined with other treatment being rendered to the covered person.","There is currently no content classified with this term.","Once you meet your deductible, the RRA can reimburse you for all eligible medical expenses you and your eligible spouse and dependents incur.","The following additional provisions apply to your coverage.","What is In Vitro Fertilization?","HRA is exhausted and the Deductible is met.","Employees must agree to work at Fairview for two years after completion of course work.","The notice describes in greater detail our practices on the use and disclosure of personal information.","Evidence of Coverage booklet.","With your PPO plan, you can directly access anynetworkor outnetworkphysicianhospitalor other health careprovider for covered services and supplies under the plan.","COBRA coverage can also trigger an extension of COBRA coverage, up to the maximum allowed.","Lab and X Maternity services.","For children, you may designate a pediatrician as the PCP.","For more information, contact Nationwide at www.","Coverage includes counseling services on contraceptive methods provided by a hysicianobstetrician or gynecologist.","Program providers are solely responsible for the products and services provided thereunder.","Also, under the Medical Plan, and pursuant to federal law, a civil union must be treated by the plan the same as a domestic partnership.","Aetna is the brand name used for products and services provided by Banner Health and Aetna Health Insurance Company and Banner Health and Aetna Health Plan Inc.","You must contact the BP Benefits Center each annual enrollment period to elect this option or another OOA option if your dependent continues to live away from home.","If any coverage your Employer allows you to continue has reduction rules applicable by reason of age or retirement, the coverage will be subject to such rules while you are on FMLA leave.","Each time you call the EAP, you speak with a counselor who can help you address your issues and concerns.","Use generic drugs when possible.","We also use cookies and other tracking technologies to collect this information.","And if you have the old site bookmarked, you may want to delete it to avoid confusion.","They may be able to do so, only if they satisfy our requirements for what we callevidence of insurability.","This is care furnished during a period of time when your family or usual caretaker cannot attend to your needs.","Behavioral health services are now covered the same as other medical services.","Used to help members find information about participating doctors, hospitals, dentists, pharmacists and other providers in an area.","We also have policies addressing circumstances in which members are unable to give consent.","Services provided by persons without nationally recognized licensure or which do not fall within the scope of the license.","This form has three sections, one that your employer will complete, one section for you to complete, and the final section is for your doctor or health care provider to complete.","Because you have no control over whether a network pharmacy is used, coverage is provided even when the prescription drugs are obtained from a nonnetwork pharmacy.","How do we use this information?","Your policy will be issued once Aetnareceivesand processes your completed application and premium payment.","Readership information is provided to publishing law firms and authors of content to give them insight into their readership and to help them to improve their content.","You can go to: Any network provider.","Employee status: Indicate whether the employee is active, COBRA or state continuation.","It is offered through plan sponsors as a group product or sold to individuals.","Is supervised fulltime by a sychiatric physicianwho is responsible for patient care and is there regularly.","The program may include educational materials and member support for monitoring the condition and treatment.","Coverage for the dependent will become effective on the date of the court order.","Employees should notify HR when this occurs.","At any time, Aetna may require copies of documents to support your claim, including data about employment.","Want to roll over funds from a previous account?","Compensation claims on your behalf by calling Constitution State Services Co.","At the time the employee requests a leave, it is your responsibility to make arrangements with the employee to collect any contributions you may require for the continued coverage.","Store the authorization token that users receive when they login to the private areas of our Website.","Starting on your first day of employment, Amazon offers a wide range of benefits to support you and your family inside and outside of work.","Medical Program for your dependents to also be eligible.","At CVS Health, we have a variety of opportunities in several career areas for you to choose from.","Charges patients for its services.","You will recieve an email notification when the document has been completed by all parties.","The POA Notice also explains the submission process for individually designated POAs, court orders and guardianships.","However, coverage will not be the same as your group plan coverage.","If you participate in the Standard PPO Option, you pay a separate plan year deductible under the Prescription Drug Program.","This does noinclude a local anesthetic.","For making this determination under COBRA, employees working for employers under common control must all be aggregated.","Notify the BP Benefits Center if the COBRA materials are not timely received.","Determining expenses that can be paid from plan assets.","If you have coverage under a motor vehicle policy including liability, Medpay, PIP, no fault, underinsured motorist or uninsured motorist, such coverage is primary and the BP Medical Plan is secondary.","Pharmacy Management Precertification Unit to request coverage as a medical exception.","Over the counter contraceptive supplies including but not limited to condoms, contraceptive foams, jellies and ointments.","Income from certain sources will not reduce your weekly disability benefits under this Plan.","Briefing is only accessible to active BP employees, Sessions are limited.","Services obtained from a facility that is not designated as an IOEfor the transplant being performed will be covered as outnetworkservices and supplies, even if the facility is a networkfacility or IOEfor other types of services.","Your domestic partner will cease being an eligible dependent as of the date you cease to satisfy any of the above conditions.","Please contact Human Resources for more information and to determine whether you qualify.","Benefit that provides for an annuity, or a series of payments made to the insured person on a regular basis, after retirement.","Aetnawill apply any rule for coordinating health care benefits after determining the benefits payable.","Medical coverage under the group contract has been discontinued.","Some HMOs do not provide coverage for domestic partners.","Each plan offers comprehensive benefits to help you and your family stay healthy throughout the year.","The weekly benefit percentage shown in the Schedule of Benefits.","If you do not, you must pay a penalty through your tax return.","BP Benefits Center will provide a Certificate of Group Health Coverage.","Information and guidance regarding benefits when employment with the City is terminated voluntarily or involuntarily.","Continuation because of a disease or injury, for instance.","The second period of disability may not be separated from the first period of disability for longer than a specified period of time and must be caused by the same or related condition.","If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.","ID card, they can then send us a copy of the prescription receipt with their member ID number marked on it.","The BP Retiree Medical Plan is an entirely separate plan of benefits with a different summary plan description.","Live in an HMO Plan enrollment area and choose to change coverage when there is not an open enrollment period, coverage will take effect only if and when Aetnagives its written consent.","Your Employer must continue to make premium payments.","This document has been signed by all parties.","If any fact as to the Policyholder or you is found to have been misstated, a fair change in premiums may be made.","This is intended to provide a summary of benefits offered to Fairview employees.","They must follow all the terms and conditions of the group agreement or group insurance policy.","If the mother is discharged before the baby is allowed to go home, the babys extended stay must also be precertified.","Separate cost sharing may apply.","For information about paid time off, please refer to the separate PTO webpage shared by your recruiter.","You have reached your eligibility date.","You can find what you need to know about health care reform on our health care reform website atwww.","Because this document is intended as a summary of a BP benefits plan, it is not intended to describe each plan provision in full detail.","The ERO must deliver the notice of Final External Review Decision to you, the Claims Administrator and the Medical Plan.","Coverage is subject to all the terms, policies and procedures outlined in this Booklet.","Whether a network or nonpharmacy is used, you may need to pay for the prescription drug up front and then file a claim for reimbursement.","Fairview partners with Securian Financial for life insurance administration.","Or you can choose to participate in a scheduled onsite class.","The people who operate your plans are called and have a duty to operate the plans prudently and in the interest of you and other plan participants and beneficiaries.","Complete the online Retirement Readiness Assessment to receive a personalized report with key action steps to improve your financial wellbeing.","Short Term Disability is company paid disability coveragefor nonoccupational health conditions.","This includes situations in which you are admitted to a network hospital and nonnetwork physicians, who provide services to you during your stay, bill you separately from the network hospital.","Sitecore compiler does not process Calc correctly.","Fill is the easiest way to complete and sign PDF forms online.","If, through no fault of your own, you are not able to meet the deadline for filing a claim, your claim will still be accepted if you file as soon as possible.","No benefit is payable if the disability is excluded by any other terms of this short term disability plan.","This may delay payment of benefits.","What retiree medical expenses are eligible?","See the separate Retiree Medical SPD for details.","To reach the Advocacy Service, call the BP Benefits Center.","To avoid any delays in processing your payments, please submit forms as soon as possible.","Human Resources also assists departments and offices in meeting their staffing goals, promoting equal opportunities, managing job performance and interpreting policy.","Certain conditions must be met for coverage to be continued.","Refer to What the Plan Covers, Exclusions, Limitationssections and Schedule of Benefitsto determine if medical services are covered, excluded or limited.","UPS employee, you can skip those steps.","The Claims Administrator must immediately send you a notice of its eligibility determination.","When contraceptive methods are obtained at a pharmacyprescriptionsmust be submitted to the pharmacist for processing.","Treatment in a hospitalis covered only when the hospitaldoes not have a separate treatment facility section.","The employee must be restored to employment and be provided with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.","Aetna Health of Utah, Inc.","IOEprogram, the program will coordinate all solid organ and bone marrow transplants and other specialized care you need.","Access a variety of resources for fitness, nutrition, stress management, tobacco cessation, mindfulness, discounts, and more through the employee intranet, blog community, and activities both online and onsite.","Employees also must inform the employer if the requested leave is for a reason for which FMLA leave was previously taken or certified.","Doctor hospital visits, surgery and related professional fees.","Retirement benefits you elect and receive under any group pension plan.","The Aetna plans contain some vision coverage.","Prescription Drug Program, call ESI.","Fidelity Investments is the administrative services provider.","Manage benefits programs and pay bills.","In reaching a decision, the assigned ERO will review the claim and not be bound by any decisions or conclusions reached during the Medical Plans internal claims and appeals process.","Eligible health services include habilitation therapy services your physician prescribes.","Grand Rounds works with top doctors and specialists across the country and identifies the highest quality physicians for your unique needs.","ID, or other identifying information shown on the front of the Explanation of Benefits form, and any other comments, documents, records and other information you would like to have considered, whether or not submitted in connection with the initial claim.","Services and supplies provided in connection with treatment or care that is not covered under the plan.","Your employer will determine the amount of your plan contributions, and will advise you of the required amount.","Coverage is effective the first of the month following your date of hire, or on the first of the month if hired on the first of a month.","An outpatient program offered by licensed psychiatric facilities that includes a day or evening treatment program for mental health or substance abuse issues.","Also included is surgery on a healthy breast to make it symmetrical with the reconstructed breast and physical therapy to treat complications of mastectomy, including lymphedema.","Optional life insurance is available at a low cost to employees for self and dependents.","Routine physicals are covered annually.","This site uses cookies to offer you the best experience possible.","Even while you are living, our life insurance plans are looking out for you.","This material is for informational purposes only and contains only a partial, general description of plan benefits or programs and does not constitute a contract.","Allstate Identity Protection protects you from unauthorized use or attempted misuse of an existing credit card or other existing account, and the misuse of personal information to open a new account or another fraudulent purpose.","It is only recognized in some states.","The premiums for HDHP coverage are lower, but the deductibles are higher.","Once the money is in your HSA, you can reimburse yourself for the amount you personally paid for the expense.","Consumer Price Index for Urban Wage Earners and Clerical Workers, is published by the United States Department of Labor.","For autologous blood donations, only administration and processing costs are covered.","Expenses that are not applied to the separate Standard Option Prescription Drug Program deductible include: Prescriptions filled at a retail pharmacy after the twofill limit on maintenance medication is reached.","If the box is checked, Aetna will move the member to your COBRA plan and they will continue to bill on your Aetna invoice.","For a list of participating health care professionals who specialize in obstetrics or gynecology, contact your Employer or, if you are a current member, your Aetna contact number on the back of your ID card.","If left untreated, the bacteria and inflammation will spread and destroy the gums and supporting bone around the teeth.","Several of the benefit programs require that you enroll within a specified period of time.","Dates expenses are incurred.","There are no benefits payable to you nor do we compensate providers for services they may render though discount arrangements.","When in doubt, start with your personal Citi Health Concierge as your first call.","Niagara accepts roll overs from other qualified plans.","Aetnawill pay for a service or supply, thenthe recognized chargeis the rate established in such agreement.","Preventive items or services with an rating from the United States Preventive Services Task Force.","If you receive a bill for any portion of your preventive exam or labs, contact the Piper Jordan Claims Advocacy team for help!","This website uses cookies to improve user experience, track anonymous site usage, store authorization tokens and permit sharing on social media networks.","To do this, write your debit card number on the bill from the provider in the space requesting credit card information.","This content is being provided as an informational tool.","If you have any questions about your health and protection plans, you should contact the BP Benefits Center.","It will tell you how coverage may be affected.","Prepared date: The date the statement was prepared.","The HDHP covers the cost of certain preventive drugs without having to meet a deductible.","In the event of a misstatement of any fact affecting your coverage under the plan, the true facts will be used to determine the coverage in force.","Please note that the information on the formulary drug list is not BPspecific, and not all of the preferred drugs covered may be listed nor does BP cover all the drugs that may be listed.","Savings OOA Option, the lower outpocket maximum amount applies if you have You Only coverage.","Note: Medicare premiums can only be for your spouse or eligible dependent, as you cannot be covered under Medicare and also contribute to an HSA.","The contractual plan documents, describing the terms and conditions of coverage, that are provided to the plan sponsor.","Some subtypes have five tiers of coverage.","Additional information if required.","Contact your HMO for its rules and procedures regarding health care claims.","The plan is not required to pay you part of any recovery it may obtain, even if it files suit in your name.","The employee must sign and date the form.","Generally, employees will want to choose a PCP for themselves and any eligible dependents when they enroll.","Certain health care services such as hospitalizationoutpatientsurgeryand certain other outpatient services, require recertificationwith Aetnato verify coverage for these services.","When you have an inpatient admission to a facility, Aetnwill notify you, your physicianand the facility about your precertifiedlength of stay.","Is set up, equipped and run to provide prenatal care, delivery and immediate postpartum care.","Once you enroll in a limited or full Health Care FSA, you cannot drop or make changes to this benefit, unless you experience an eligible status change or qualifying life event.","The program must include reviews byhysicianwho do not own or direct the facility.","These plans are designed to give you and your family additional benefits beyond your standard medical, dental, and vision plans.","Such right does not affect any other right of recoverythe Planmay havewith respect to such overpayment.","Contact the BP Benefits Center for more information.","To keep this Web Part, click Cancel.","In that case, complete the claim form and mail it to the address on the claim form.","Any coverage being continued for a dependent will not be continued beyond the date it would otherwise terminate.","Anyone who receives your information for purposes of providing you services as part of the wellbeing program will abide by the same confidentiality requirements.","Washington DC, California and Massachusetts are three of the most expensive states to care for your child when working.","Your PCP will direct your care, including providing referrals to see a specialist.","Fraudulent misstatements in connection with any claim or application for coverage may result in termination of all coverage under this plan.","BP reserves the right to amend or terminate a plan at any time without advance notice.","In addition, and subject to legal and contractual considerations, BP reserves the right to terminate your employment at any time or for any reason.","Important Note Please read this section carefully.","The Patient Protections provided three new requirements that plans must follow.","Render slideshow if info advacned items contain one.","What else you should know about claims administrators under the BP Medical Plan The claims administrators for the benefits and services provided under the BP Medical Plan are business entities independent of BP and independent of each other.","Disability benefits under any group mortgage or group credit disability plan.","Savings PPO Option has two separate outpocket maximum amounts for network expenses, and two more for outnetwork expenses.","The geographic area the HMO or PPO is licensed to operate in or, when licensing is not required, the area where an adequate network exists to provide covered services.","Benefit and lifetime maximums also apply.","This twoyear period begins with the date of the first morbid obesity surgical procedure, unless a multistage procedure is planned.","In this case, your eligibility for BP Retiree Medical Plan coverage will commence the first of the month following the date of the events indicated above.","The date you refuse to be examined by or cooperate with an independent physician or a licensed and certified health care practitioner, as requested.","Deductible, then Prescriptions purchased at an outnetwork pharmacy are covered only if a network pharmacy is not available.","You took drugs which were prescribed or recommended by a physician.","If applicable, complete your State Disability Insurance application and submit requirumentation, including your medical certification.","Your benefits are subject to the maximum shown in the Schedule of Benefits.","Furthermore, HR supports employees and their supervisors in reconciling differences and achieving harmony to promote effective work relationships that adhere to the values of a Catholic institution.","Not all medical expenses are covered under the plan.","Outpatient physician and facility care.","SHRM provides content as a service to its readers and members.","We do not discriminate against, exclude or treat people differently because of race, color, national origin, age, disability, sex, sexual orientation, gender or gender identity.","Law prohibits group health plans from terminating the coverage of a dependent child enrolled in a post secondary school educational institution on a medically necessary leave of absence which results in the loss of student status.","The primary planpays or provides its benefits as if the secondary planor plansdid not exist.","You can find the forms on www.","Subrogation and Right of Recovery Provision.","Savings PPO Option only, you must satisfy the applicable individual or family deductible first before the office visit copay will apply for these services.","At CVS Health, we share a clear purpose: helping people on their path to better health.","You may elect to receive this notification by email, or through the mail.","Refer to the Understanding Precertificationsection for more information on the precertificationprocess and what to do if your equest for precertificationis denied.","You can use your HSA to pay for all outpocket eligible medical expenses.","An employee on an unpaid leave of absence not approved by BP.","Your establishment of your domestic partnership.","In Utah and Wyoming, by Aetna Health of Utah Inc.","The premiums listed below are applicable no matter which Aetna plan you choose.","Occupational therapy does not include educational training or services designed to develop physical function.","It will be reviewed subject to the same timeframes applicable to formal appeals for benefits.","Include the remittance stub, and use the mailing envelope provided.","This includes both plans that are insured and those that are not.","They have a dedicated team of employees to answer calls and process claims.","Precertificationshould be secured within the timeframes specified below.","You may elect another BP Medical Program option.","Keeps a medical record on each patient.","High Deductible Health Plan.","You may receive a bill for the difference between the amount billed by the outnetwork provider and the amount paid by Aetna.","You are eligible for vacation, personal days, sick days, and holidays.","In connection with a pregnancy for which pregnancy related expenses are not included as a covered expense.","HMO eligibility may vary.","So does our online provider directory at www.","Written proof must be provided for all benefits except any Short Term Disability Benefit.","After a Final External Review Decision, the ERO must maintain records of all claims and notices associated with the External Review process for six years.","Refer to the Schedule of Benefitsfor the visit maximum that applies to the plan.","The s office or other provider may send you a bill requesting payment for the difference between the billed charges and the amount covered by your health plan.","To do so: if you or ANY of your enrolled dependents are eligible for Medicare.","Access and print forms for your benefit plans and employee programs.","These services need to be provided during intermittent visits of four hours or less, with a daily maximum of three visits.","Present your Magellan ID card along with your prescription each time you visit your pharmacy.","Aetna member portal will be changing to the new Aetna Health portal.","No benefit is payable for or during the elimination period.","If the employee acquires a new dependent while coverage is being continued under the FMLA, the new dependent may also be eligible for coverage.","You can always check this page for the latest version.","Services of a certified or licensed social worker.","Inpatient benefits are payable only if your condition requires services that are only available in an inpatient setting.","If you contact the EAP by phone, you are eligible for up to six phone counseling sessions at no cost.","VANDERBILT UNIVERSITY MEDICAL CENTER ORIENTATION GUIDESPDs are available at hr.","Under all plans, you must pay a monthly premium to cover eligible family members.","However, if a dependent has a remaining benefit, he or she is eligible to convert.","It is determined by factors such work experience, job history or the job market.","Written proof must be provided for all benefits.","When your employee files a Leave or Disability claim, they are connected to the right support right from the start.","Coverage for dependents may continuefor a period after your death.","Additional life insurance which members buy beyond the amount of basic coverage paid for by the employer.","Send page view for new tracker.","STD are exhausted, the company will no longer pay the employer portion of your benefits.","Savings OOA Option, the lower deductible applies if you have You Only coverage.","Federal regulations do not allow you or your spouse to contribute to both an HSA and BPs HCFSA.","FMLA provides job protection and benefit continuation while on an approved leave.","All statements made by the Policyholder or you shall be deemed representations and not warranties.","Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellbeing program, we will notify you in accordance with applicable law.","Member Services number on your ID card or go to: www.","An accelerated death benefit is available in certain situations involving a terminal illness.","Note: Your Go for the Gold wellness credit is included in the total HSA contribution limits set by the IRS.","The Jones Act or The Maritime Doctrine of Maintenance, Wages and Cure.","We consider these activities key for the operation of our health, disability and life plans.","Whether you already have a family, or are just starting out, these benefits have family in mind.","We use and disclose personal information listed above without member consent to the extent the law allows.","Women do not need to obtain authorization from their HMO or PCP to obtain access to obstetrical or gynecological care from HMO network providers who specialize in obstetrics or gynecology.","Please see below to download the forms.","An event or process that occurs during pregnancy that is not associated with a normal pregnancy.","You can keep any remaining money you have saved in your HSA year after year, even if you leave BP.","Refer to the current Rotator Supplement and the Expatriate Medical Plan Summary Plan Description for more information.","Treatment is generally provided by a mental health professional such as a psychiatrist, psychologist or psychiatric social worker.","These include: Termination of employment, either voluntarily or involuntarily, for reasons other than gross misconduct.","The process of receiving approval for some health care, such as hospitalization, outpatient surgery or prescription drugs, before it can be covered.","To enroll, terminate or make changes to Group Term Life Insurance.","In all other instances, you are responsible for obtaining any required precertification.","Maternity and newborn care.","Your dependents who are pursuing health care education also may qualify for a scholarship.","You have successfully removed bookmark.","If you are outside the United States, you can go to any pharmacy, have your prescription filled and pay the full cost for it.","You are not required to designate a primary doctor or have your primary doctors referral to see a specialist.","See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage.","As a result, neither BP nor the plan administrator can interfere in medical or administrative decisions made by an HMO or direct the HMO in any way regarding benefits or coverage.","Facebook, Twitter and other Social Network Cookies.","Please log in as a SHRM member.","The fee or charges incurred to receive coverage by an insurance company or carrier.","American health care is often praised as offering some of the best medicine and procedures in the world.","Set the moment library locale to the currently selected Amazon.","Mandatory contributions will be in addition to any voluntary contributions you elect.","If you need additional sessions beyond the six EAP sessions, your BP Care counselor may refer you to a local behavioral health care or medical provider.","Fill out the authorization form and fax it to us at the fax number below.","Each BP PPO Option has separate network and outnetwork medical coverage plan year outpocket maximums.","All covered health benefits are payable to you.","Fromhome to hospitalfor covered inpatient or outpatient treatment when other means of transportation would be considered unsafe due to your medical condition.","Reimbursement Accounts, FSA Eligible and Ineligible Expenses List.","You may submit written comments, documents, records and other information relating to your claim, whether or not the comments, documents, records or other information were submitted in connection with the initial claim.","The BP Enhanced Aetna Concierge team can do many things for you: Schedule appointments with your doctor.","Most American employers offer generous benefits packages to their employees.","For language services, please call the number on your member ID card and request an operator.","Aetna know when your employment ends.","Retirement has a separate enrollment process.","Cut out cysts, tumors, or other diseased tissues.","Resets status after page change.","Treatment of mental disorders, custodial care and other treatment in an institution that is not a legally constituted hospital, except as covered under the plan.","If you have an HSA in one year and choose a BP medical option that doesnt allow for HSA contributions in a future year, you can still use any balance remaining in your HSA for health care expenses.","Without regard to your specific reporting relationship.","Illness A pathological condition of the body that presents a group of clinical signs and symptoms and laboratory findings peculiar to the findings set the condition apart as an abnormal entity differing from other normal or pathological body states.","Complete the attached authorization form.","Compensation benefits for Citi.","This program puts a team of benefits specialists at one location at your disposal, waiting to resolve all of your healthcare coverage questions and concerns.","The plan limits coverage to one item of equipment, for the same or similar purpose and the accessories needed to operate the item.","Employees have the option to enroll in the vision plan administered by VSP.","The decision of the independent external expert reviewer is binding on you, the Claims Administrator and the Medical Plan unless otherwise allowed by law.","Certificate describes the rights and obligations of you and Aetna, what the plan covers and how benefits are paid for that coverage.","Medicare Direct electronically links Medicare as the primary payer with Aetna as the secondary eliminating the need for a member to file a claim to Aetna for secondary consideration.","If left untreated, plaque can begin to mineralize and harden into calculus or tartar.","Care to support and reduce pain for a terminally ill person, either on an inpatient or outpatient basis, and to support his or her family.","Umm, there are items that require your attention.","If they bill with an existing or new diagnosis, you will be charged for an office visit.","While Fitbit is still the recommended tracking device, you have the option to connect other devices to the challenge.","NIAGARA WATER does not sponsor, maintain, endorse, recommend, or promote these voluntary programs.","An organization providing inpatient and outpatient medical services, which is accredited as a hospital by the appropriate industry organizations, or otherwise determined as meeting reasonable standards.","You may only use your available balances to supplement your pay.","Once logged in, Navigate to the Message Center, compose your message, attach your scanned form, and send.","This page is a summary of benefits only.","VUMC employees enrolled in one of the three health plan options.","Student Connection for specific terminology as it relates to your school health insurance plan benefits.","See your BRG lead to find out about upcoming events that are eligible for points.","The Order of Benefit Determination Rules below determines which lanwill pay as the primary plan.","The OOA Options pay most of the cost of covered expenses up to what is considered a recognized charge after you meet the plan year deductible.","Establishing rules and procedures for plan administration.","Penalties include imprisonment, fines, and denial of insurance benefits.","Active Employee or Retired or Laid off Employee.","Offered through The Hartford!","Child Covered Under More than One Plan.","Also, it provides, or arranges with a hospitalin the area for, any other medical service that may be required.","Change in health insurance eligibility due to a relocation of residence or work place.","If not already preprinted, please add.","Learn more in the Summary Plan Description at hr.","An employee assigned a position that: Requires fulltime service as determined by BP; Is established to fill regular and ordinary employment requirements; and Is expected to continue for an indefinite period of time.","News, trends and analysis, as well as breaking news alerts, to help HR professionals do their jobs better each business day.","If you miss the enrollment period, you will not be able to participate in the plan until the next annual enrollment period, unless you qualify under a Special Enrollment Period, as described below.","Psychiatric, psychological, personality or emotional testing or exams.","Product type and premium: The product and total premium charged per subscriber.","See the HSA Quick Reference Guide for tips on how to choose your investments online.","Clients are urged to consult with their own legal, accounting and tax advisors with respect to their specific situations.","If you are rehired Occasionally, retired BP employees are rehired.","Eligibility and participation Learn about the eligibility rules governing the Medical Program Who is eligible You are eligible to participate in the Medical Program if you are classified as a fulltime, parttime or temporary employee of a participating employer.","The replacement can be complete or in part for the eligible class to which you belong.","Providers are independent contractors and are not agents of Banner l Aetna.","You can start, stop and change your contribution amount at any time, as long as you dont exceed the annual maximum.","This is because NAP providers typically charge plan participants lower, contracted rates.","Are you a Massachusetts resident?","The lien is in the amount of benefits paid by the plan for the treatment of the illness, injury or condition for which another party is responsible.","Anabolic steroids, tretinoin, weight loss management, photoaged skin products and erectile dysfunction drugs are available only through the home delivery program, subject to plan limits.","There are also additional election opportunities.","Your beneficiaries may also ask your employer to file the claim for them.","Please sign up for an account.","Savings PPO Option, you must meet your medical plan deductible before copays are applicable.","Download the Aetna Health app to your personal device today.","Claims Administrator for the planshall have the sole authority and discretion to resolve all disputes regarding the interpretation of this provision.","Names of physiciansdentistsand others who furnish services.","Both full time and part time employees are eligible for the full spectrum of benefits here at St.","The Elimination Period is the amount of time you must be disabled before benefits start.","The secondary and tertiary plans adjust their benefits so that the total benefits paid by all plans will not be more than the total covered expenses.","PCP must approval referrals to specialists.","See Special Enrollment Periodssection of the Booklet.","We want you to have the vaccine as soon as possible and will let you know as soon as we are ready to schedule your appointment.","Special rules on switching between the Health Care Flexible Spending Account and the Health Savings Account can limit your ability to enroll in certain medical options in the middle of a plan year.","Refer to the applicable summary chart for more Not all services are available at all walkin clinics.","FMLA leave of absence, the following information describes how this will affect your Aetna group life insurance coverage.","Emergency room copays will still apply as they are not subject to the outpocket maximum.","The plan covering that same person as a retired or laid off employee or as a dependent of a retired or laid off employee is the secondary plan.","During annual enrollment each year, you will be notified of the required contribution for your available coverage options for the upcoming plan year.","You do not need manager approval for Ramp Back.","Services on the Fairview intranet.","Fairview uses the Aetna Signature Administrators national provider network for discounted services.","Network expenses do not count toward meeting the outnetwork medical coverage outmaximum.","If you do not enroll for coverage when you first become eligible, but wish to do so later, your employer will provide you with information on when and how you can enroll.","If you worked at TNKBP and then returned to work at BP prior to separating from BP, your service with TNKBP counts toward the years of service calculation for purposes of determining the applicable participant premium percentage.","It does not build up cash value.","Colorado division of insurance within the department of regulatory agencies.","CVS Health is an equal opportunity and affirmative action employer.","The employee is retired but has not already changed to Medicare for their primary coverage.","This includes, but is not limited to, the payment of premiums.","You will receive wholesale prices on brand name prescriptions, preventives and more.","You will be responsible for your payment percentageup to the maximum outpocket limitapplicable to your plan.","When the COB rules of hislanand another plan both agree that hislandetermines its benefits before such other plan, the benefits of the other plan will be ignored in applying the general rule above to the claim involved.","Charges for services not ordered by a covered provider.","Permits all area medical personnel to utilize its services for their patients.","In seconds, it will get you and your employees to the right customer service professional.","Aetna Health app from the App Store or on Google Play.","Speech therapy that is custodial or educational or is not restorative in nature.","Each participant is automatically provided with a copy of this summary annual report.","It may also specify that you are required to periodically report back to your employer during your leave to let them know when and if you expect to return to work.","An employee or dependent cannot retroactively elect a continuation provision, such as a state or COBRA continuation, while they have an extension of benefits.","NME Program will help pay certain travel and lodging expenses for you and a companion.","Form used to delete benefits.","If you are not part of the group that this document applies and, as a result, have received this document in error, please contact your recruiter or human resources to receive the documents applicable to you.","Your sales support team can advise you.","Change most dependent information, including name, birth date and relationship.","For the most update information, including whether a provider is accepting new patients, call the provider.","If you want to change to a different PCP, you need to contact your HMO.","Additional visits are not covered.","IRS Website at www.","If you are covered by a collective bargaining unit, other plan terms may apply.","However, COB may occur if a person receives emergency services that would have been covered by both plans.","Many drugs on it are subject to rebate arrangements between Aetna and the manufacturer.","Optional life insurance coverage is available for purchase for you, your spouse, and dependent children.","See Recognized charge Eligible claims incurred in an emergency room facility will be covered at the applicable innetwork benefit level.","Identification of available community resources; and Assistance provided to you to obtain resources to meet your assessed needs; Consultation or case management services by a physician; Medical supplies and prescription drugs; Dietary counseling; and Psychological counseling.","Street, city, state, ZIP code.","We are also hiring nurses in most states.","Services may vary and may not be available in all states.","Aetna will contact the External Review Organization that will conduct the review of your claim.","In most instances the employee will be relying on AXA to help arrange the services and AXA and the vendor work out the payment arrangements.","Charges made by a physicianor transplant team.","Provides benefits payment to an eligible survivor after a disabled insured person has died.","EAP counseling session and then leave BP or are no longer eligible, you may complete all three sessions related to the initial issue you consulted the EAP about if the sessions are completed within the same calendar year.","There is an ongoing clinical trial.","Six weeks of paid leave following the birth or adoption of a child.","The weekly or monthly rate of basic earnings in effect on the day before becoming disabled.","COBRA Direct Bill unit.","Prescription drug expenses apply to the plan year deductible and outpocket maximum.","Is set up, equipped and run to provide general surgery.","Learn more on the Go for the Gold website at vumc.","Option and you use a network provider for covered medical care, the provider will take care of precertification for If you use a NAP provider, confirm that the provider is obtaining precertification on your behalf; otherwise contact Aetna directly for precertification.","Services of a resident physicianor intern rendered in that capacity.","Your medical services must be provided by a doctor who accepts Medicare.","The date you are required to make any contribution and you fail to do so.","The date your Employer determines your approved FMLA leave is terminated.","Are the leaves provided paid or unpaid?","If you do, the excess will be taxed as ordinary income and is subject to a penalty.","These discount arrangements are not insurance.","Medicare, or children reaching limiting age.","Aetna is responsible for the cost of sending this information to the External Review Organization and for the cost of the external review.","If you have any questions about our coverage of mastectomies and reconstructive surgery, please contact the Member Services number on your ID card.","Outpatient rehabilitation for learning disabilities, developmental delays and autism, except as noted otherwise in this SPD.","If a terminated person later elects COBRA, coverage will be reinstated retroactive to the termination date.","Determining When You Become Eligible You become eligible for the plan on your eligibility date, which is determined as follows.","For some appointments or services, we require that you complete forms.","Failure to give proof that the disability continues.","Search for jobs at St.","The date you no longer meet the short term disability test of disability, as determined by Aetna.","Treating someone at home with drug therapy that is given through a vein.","If you continue to use your current browser then Fill may not function as expected.","This is your medical coverage plan year outpocket maximum.","VUMC contributes to your HSA.","Penalties may include imprisonment, fines or denial of insurance benefits.","Plus and Select members.","You may then submit the expense to Aetna for consideration.","This might happen when an employee goes from full time to part time or when an increase in premium costs results in the loss of coverage.","United States; or the purchase of such prescription drugsor supplies outside the United States is considered illegal.","It does not require fulltime confinement.","Not for exercise or training.","Click any icon below to search and apply for jobs.","The policy defines eligibility, elimination period, and terms and conditions.","No term available for this letter.","While few benefits are statutory, many companies realise that the only way to attract skilled workers and to ensure a happy and productive workforce is to offer a wide range of enticements.","If they apply, employees may be eligible for continuation as prescribed.","Develop any impaired function, or Relearn skills to significantly develop your ability to perform activities of daily living on your own.","Aetna considers personal information to be confidential and has policies and procedures in place to protect it against unlawful use and disclosure.","Notify your manager or supervisor and HR representative of your absence from work.","Refer to the Schedule of Benefitssection for the amount of precertificationbenefit reduction that applies to your plan.","Citi will contribute money into your HSA each year that you are eligible to help cover out of pocket expenses.","It is further agreed that the plan is not required to participate in or pay court costs or attorney fees to the attorney hired by the participant to pursue the participants damage claim.","Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.","BP retirement plan counts such prior service as vesting service, then that service will be taken into account when calculating either the amount of subsidized premium or the RRA annual credit, as applicable.","You or your dependents are eligible for Medicare.","Health care professionals in our network should file claims for you.","Attention Colorado Residents: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company.","Talk with your physician during your appointment to ensure you are billed correctly.","You can download or view the documents listed below.","Handicapped Child Attending Physician Statement.","Program coordinates care when an Aetna plan participant develops an urgent or acute illness when traveling outside of the United States.","YMCA and Planet Fitness.","Other parties need to complete fields in the document.","Please refer tothe cheduleof Benefitsfor specific information on payment percentageamounts.","If you missed Open Enrollment, please contact your HR representative immediately.","Not ready to apply?","Transition care benefits are paid at the higher, network level of benefits for a limited period of time so you can complete an active course of treatment.","Treatment received without preauthorizationwill not be covered.","Note: Prescriptions purchased at an outnetwork pharmacy are covered only if a network pharmacy is not available.","Savings Options, refer to the BP Wellness Program detailed elsewhere in the SPD.","For more information about Aetna plans, refer to www.","Longer or Shorter Length of Coverage.","Aetna may proceed against any party with or without your consent.","If you or your spouse are insured by Aetna for health care, you will be asked to provide and disability claim management in order to coordinate care.","Medicare, your RRA may be used for certain types of expense, as follows: Until you meet your deductible, your RRA can be used only for certain types of expenses, including Medicare premiums and eligible outpocket vision, dental and preventive care expenses.","Some states include siblings, grandparents, domestic partners and others in the definition of family member for the purposes of family medical leave.","Debit and credit adjustments will be displayed separately by date.","Fairview partners with Optum for HSA administration.","It must give proof of the nature and extent of the loss.","If the coverage of any person under this Plan replaces any prior coverage of the person, the following will apply.","The lifetimemaximumsthat apply to infertilityservices apply differently than other lifetime maximumsunder the plan.","You can buy supplemental life insurance coverage for yourself, payable to your designated beneficiaries if you die.","Your employer is required to foot the bill for these opinions.","Resources for you today.","You can write your HSA debit card number on the doctors bill and submit it as payment, or you can pay for the expense out of pocket and reimburse yourself later.","This includes, but is not limited to, refraining from making any settlement or recovery which specifically attempts to reduce or exclude the full cost of all benefits paid by the plan.","Consolidated Welfare Benefit Plan.","Services or supplies that are not medically necessary as determined by the claims administrator.","This will give you access to the Niagara discounts and two days worth of parking points will automatically be added to your account.","During this period, you have the option to change your coverage.","The amount of the other income benefits will be subtracted from your weekly short term disability benefit for which you are eligible.","The extension applies to the timelines for claimants to bring benefit claims or appeals for consideration.","Since there are a number of factors that determine whether a discount will be given, Aetna is unable to guarantee any level of discount under this program.","For example some benefits are limited to a certain number of days, visits or a dollar maximum.","Program coordinates transplants and other specialized care that may not be available in your local area.","Keeps a complete medical record on each patient.","The Administrator may make a reasonable charge for the copies.","You will need to connect your tracking device to the new portal.","Coverage for each health plan option.","The date of termination of the domestic partnership.","Health Reform Connection can help you learn more about how the health care landscape is changing because of the law, and what health care system challenges remain.","For questions or to submit claims to a BPoffered HMO, contact your HMO directly.","Treatment that uses exercise and physical movement to relieve pain, restore use, promote healing and prevent disability in a part of the body.","It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan.","Such criteria are based solely upon the conditions related to your employment.","Remember to keep all receipts and documentation for future reference or to answer any questions that may arise.","Have them turn off paper and start viewing all their Aetna communications online.","The first disability will not be included if it began while you were not covered.","Any paid job for which a disabled employee is, or may reasonably become, suited by training, education or experience.","The extension of COBRA coverage applies to all family members of the disabled person, even those family members who are not disabled.","The Aetna Medicare Supplement Plan will process second and pay additional amounts not covered by Medicare.","Your outpocket costs may vary between network and outnetwork benefits.","An ERO must make such records available for examination by the claimant, the Medical Plan, or state or federal oversight agency upon request, except where such disclosure would violate state or federal privacy laws.","Medicare as primary coverage, refer to the enrollment section of this manual.","You decide how much of your pretax wages you want taken out of your paycheck and put into an FSA.","Death of a covered employee.","Want to add a signature?","Also, the monthly credit will be based on your above point calculation as of the end of the month, even if the applicable point calculation changes in the middle of the month.","Charges made by a provider for complex imaging and ultrasound tests that exceed the following maximum when multiple complex imaging and ultrasound tests are performed by the same provider on the same day.","If you give evidence that the HMO Plan provides an extension of benefits for disability or pregnancy, coverage under this plan will be extended.","Group type contracts are those which are not available to the general public and can be obtained and maintained only because membership in or connectionwith a particular organization or group.","Examples of these types of situations are major medical coverages that are superimposed over base plan hospitaland surgical benefits, and insurance type coverages that are written in connection with a closedpanelplanto provide outnetwork benefits.","Other Eligible Individual relationship, adoption, etc.","Charges for one morbid obesity surgical procedure, unless a multistage procedure is planned.","This will be done unless you have told Aetnaotherwise by the time you file the claim.","Most of your administrative work is likely to be enrollment and benefits changes.","You may never receive more than the actual charges.","Click on the links below for more information.","Stay in communication with your People departmentrepresentative regarding any updates orchanges to your leave.","Your coverage under this Plan replaces and supersedes any prior coverage.","Keeps complete medical records on each person.","This digital learning will cover why you need sleep and how much you need; types of sleep; improving sleep habits and sleep efficiency; and understanding shift work and sleep.","During the first two years that your insurance is in force, any statement that you have made may be used by Aetna in contesting the validity of that coverage.","Two or more periods of disability that are related in diagnosis and separated by a period of time defined by the contract.","Be aware that covered services and treatments may vary from HMO to HMO and may be different from those provided by the BP Medical Plan.","If a service or supply you need is covered under the plan but not available from a networkprovider, please contact Member Services at the tollfree number on your ID card for assistance.","Many pharmacies will not accept insurance unless the member presents their member ID card.","COBRA continuation coverage information is below.","Customer Service Department for assistance.","Terminated and rehired: Employees who leave the company and are then rehired within one year do not have to serve a new probation period before they become eligible for benefits.","Subject to verification procedures that the Medical Plan may establish, your Authorized Representative may act on your behalf in filing and pursuing this voluntary appeal.","While we intend to update this summary on a regular basis, it is possible that at any point this summary may be neither current nor complete.","An additional benefit may be available if the member dies while properly using a passenger restraint system.","Need help with claims issues?","Required for all employees.","Please note: Aetna does not prorate premium for terminations.","This form is very important and will help expedite the handling of your claim.","The charges to receive coverage from an insurance company or carrier sometimes categorized by subscriber and additional dependents.","In order for this special treatment to apply, the alleged provider deficiency must be raised with Aetna Member Services in advance of treatment and Aetna must agree with the special treatment.","Name, subscriber ID: Lists the name and SSN of each subscriber.","Control, suffix and account numbers: If not already preprinted, please add.","The information you will be accessing is provided by another organization or vendor.","Official retirees and employees not receiving a payroll check will be billed.","It must have been sponsored by your Employer who is participating in this Plan.","Log on to the Aetna website at using your Aetna login information.","It is also possible that they will remain enrolled under your Aetna group plan.","If your spouse also works at VUMC, waives Health Plan coverage, and is covered as your spouse on the VUMC Health Plan, they are not eligible to receive the Wellness Credit.","Call, just call the number on the back of your ID card.","The current charges based on active membership as of the prepared date.","Get the current value.","The use of this website is subject to the Legal Conditions and Terms of Use, and by proceeding, you acknowledge your acceptance of these terms.","Provided below is a short description of each subtopic.","Refer to the How the Plan Workssection for details about precertification Refer to the Schedule of Benefitsfor details about transplant expense maximums, if applicable.","Savings Options, including behavioral health care, are all administered by Aetna.","BCBSIL, and all done in order to provide you with services under the wellbeing program.","You may be required to pay the charges and submit a claim form for reimbursement.","Prescriptions filled at a nonnetwork pharmacy when an ESI network pharmacy is available.","The amount you elect will be deducted over the number of pay periods remaining in the year.","Savings Options, you may need to pay the provider in full and submit a claim for reimbursement from your claims administrator.","Examples include prescriptions, doctorsoffice visits, and vision and dental care.","You are no longer totally disabled, or become covered under any other group plan with likebenefits.","Claims and Appeals section includes you and your Authorized Representative.","It is not a legally binding document.","This exclusion does not apply in a Medical Emergency or in an Urgent Care situation.","Aetna will determine the usual charge level if a Medicare fee is not applicable.","An increase in other income benefits that you are eligible for may affect your benefit payable under this coverage.","If a covered person is enrolled in two or more closed panel plans COB generally does not occur with respect to the use of panel providers.","Charges for its services.","You will then need to file a claim with ESI and submit it with your original itemized receipt.","GBS Americas, or an eligible dependent of such person, you are eligible for the BP Medical Program; however, your benefits are described in a separate Summary Plan Description.","Register your domestic partnership or civil union in accordance with registration requirements in the state in which you and your domestic partner or civil union partner reside.","Prioritization Among Populations and availability is based on supply.","Note: If the effective date of the enrollee transaction occurs on a date other than a statement due date, we will not charge or credit for the days in the short month.","Niagara pays for some of these benefits, while others are voluntary additional programs you may wish to purchase to enhance your benefits package.","Penalties may include imprisonment, fines, denial of insurance and civil damages.","Have opportunities for additional RSU grants.","FAIR Health reviews and, if necessary, changes these rates periodically.","You must submit appropriate documentation if you are adding coverage for a If you have a qualifying status change.","FMLA leave is deemed terminated by your Employer, you may, on the date of such termination, be eligible for Continuation Under Federal Law on the same terms as though your employment terminated, other than for gross misconduct, on such date.","Aetna primary to Medicare primary.","We comply with applicable Federal civil rights laws and Minnesota laws.","Consolidated Welfare Benefit Plan to any party, regardless of when such improper conduct was taken or discovered.","Identity Theft includes: Credit Report, Daily Credit Monitoring, and more.","Go for the Gold by going to vumc.","Important Note The loss of a professional or occupational license or certification that is required by your own occupation does not mean you meet the test of disability.","Let us know what we can do to make your job easier.","Amount due: The total amount due on the account as a result of the cumulative balance.","Form used to submit reimbursement request for eligible health and dependent care expenses.","What the Plan Coverssection.","Do you want to end your contract with us?","If you use a provider who is not a participating NAP member for a covered expense, your costs may be higher since the provider has not agreed to charge participants lower rates.","Special education to instruct a person whose speech has been lost or impaired, to function without that ability.","This Policy applies solely to the information collected in connection with your use of our Website and Services and does not apply to any practices conducted offline or in connection with any other websites.","Aetna Health of California Inc.","You can get a copy of our Notice of Privacy Practices from us.","For example, we place a session cookie on your computer each time you visit our Website.","Physical, occupational and speech therapy.","The OOA Options cover a broad range of medical services and supplies, including preventive and emergency care.","As a result, one or more Web Part properties may contain confidential information.","ID cards vary according to the plan selected and state legislation.","Central States, Southeast and Southwest Areas, Health and Welfare Fund.","If you are dissatisfied with the appeal decision on an urgent care claim, you may file a second level appeal with Aetna.","You must meet the deductible before the Option pays any benefits, other than certain preventive care.","You become entitled to Medicare.","Remember plan contributions are subject to change.","The ERO will review all of the information and documents timely received.","Benefits under the Federal Social Security Act, Railroad Retirement Act, Canada Pension Plan and Quebec Pension Plan.","You always pay the lesser of the actual cost of your prescription or the copay.","An annual deductible is required before this plan pays benefits; this plan uses a broader network of providers.","If you ask for any health information, Aetna may disclose details of the information you ask for to your doctor.","Retiree Medical Plan to one that did, and you met BP Retiree Medical Plan eligibility at the time you left the nonparticipating employer, your annual credits were based on your age and your total vesting service in a BP retirement plan.","Any outpatient disposable supply or device, including sheaths, bags, elastic garments, support hose, bandages, bedpans, syringes, blood or urine testing supplies, and other home test kits; and splints, neck braces, compresses, and other devices not intended for reuse by another patient.","To delete this Web Part, click OK.","Infusion therapy is the intravenous or continuous administration of medications or solutions that are a part of your course of treatment.","This document describes the main features of the plan.","We also provide three different dental programs as well as comprehensive prescription drug and vision care coverage.","Once you notify the BP Benefits Center of the loss of eligibility, your contribution will change as of the date of notification.","Therefore, if you do not agree with a claims administratordetermination regarding benefits that have been paid or provided, you must pursue the matter through the claims and appeals process with the applicable administrator to which claims and appeals have been delegated.","Responsibility for filing claims The following can help you determine when providers will file claims on your behalf and when you must file claims directly with the appropriate claims administrator.","What if your spouse or partner or child dies or is badly injured?","The choice or requirement to visit another doctor or surgeon for an opinion about a diagnosis, treatment or type of optional surgery to be performed.","Jaw Joint Disorder Treatment.","By noncontributory plan, we mean the whole premium is paid by you, the employer, or by the union.","If the credit is not used, the money will roll over each year.","These are services which are not solely related to your care.","The medicine is put under the skin, into a muscle, or into a vein.","The policy defines eligibility, elimination periods, and terms and conditions.","Banner Health and Aetna Health Plan Inc.","Annual Physical Report Form.","This system transition is part of our ongoing goal to better serve our members and improve their experience.","Also, your human resource officer can help you locate the correct request application for your situation.","The last day of the month for which the last contribution was made within the required time period.","You may contact Aetna to determine your remaining deductible.","This can happen if an employee did not choose our coverage because they were already covered under another group plan and then lost that coverage because of one of the HIPAA qualifying events listed below.","This certificate proves that you were covered under this plan when you were employed.","Is staffed by psychiatric physiciansinvolved in care and treatment.","Family and Medical Leave Act.","To access your account information there are three options.","While plan benefits are not funded by the claims administrators, the claims administrators are solely responsible for making determinations regarding benefits and services provided based on the provisions of the BP Medical Plan.","Please log in as a SHRM member before saving bookmarks.","Charges made by a hospita, outpatient facility or physicianfor the medical and surgical expenses of a live donor, but only to the extent not covered by another plan or program.","Autism Spectrum Disorder is defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.","Specific questions should be addressed to your doctor.","If you choose to make contributions to your HSA, you must make an election each year during the Open Enrollment period.","Citi medical plan will pay a percentage of these costs.","Reimbursement is paid upon finalization of the adoption.","Aetna arranges for the provision of health care services.","You can enroll in or change these benefits at any time during the year, not just during Open Enrollment.","Department of Labor or you may file suit in a federal court.","Medical supplies and prescription drugs; Psychological counseling; and Dietary counseling.","Provides an ongoing quality assurance program.","Provided Life Insurance Coverage Enough?","Note: If you are being direct billed by Aetna, make sure premiums are being collected.","Digital signatures are secured against your email so it is important to verify your email address.","Learn more at hr.","Every month a new educational session will be released!","You go on a leave of absence and do not want to maintain coverage while on leave.","If the volume of charges in a single threedigit zip code is sufficient to produce a statistically valid sample, an expense area is made up of a single threedigit zip code.","You pay for services and file a claim with Aetna.","In addition, Fairview will match employee contributions on a per pay period basis.","The amount of money a member pays to a participating pharmacy for prescription drugs covered by a pharmacy benefits plan.","If the employee does not return to work when this continuation period ends, the employee, along with any covered dependents, may be eligible for any other continuation provision of your group plan for terminated employees, such as COBRA.","Precertification penalties and amounts above recognized charges do not apply to the plan year deductible or outpocket maximum.","Any coverage amount that requires EOI will not take effect until necessary approval is obtained through Securian.","Claims when there is an accident can take longer.","You will need to enroll in a manner determined by Aetna and your employer.","This notice is not required if your group plan is an administrative services contract.","It is for information only as it contains only partial and general descriptions of the process and obligations from the COBRA statutes and rules.","Any changes you make must be consistent with your qualifying status change.","Savings option, the lower outpocket maximum amounts apply if you have You Only coverage.","They will be required when a claim is made.","Coverage under the plan has been in effect for less than three months.","Can you afford health insurance?","Institutional care, including room and board for rest cures, adult day care and convalescent care; and Help with daily living activities such as walking, grooming, bathing, dressing, getting into or out of bed, toileting, eating or preparing foods.","This material is for information only and is not an offer or invitation to contract.","The idea is to explain why your absence from work is necessary.","Schedule of Benefits, if any.","The occurrenceor event must be definite as to time and place.","Total current empl charges: The total amount by product and the total current charges.","Cut into gums and tissues of the mouth.","The Aetna Health Savers Plan comes with an HSA account.","This form authorizes the release of the treatment information we need to process any benefit for which you may be eligible.","No written statement made by you shall be used by Aetna in a contest unless a copy of the statement is or has been furnished to you or your beneficiary, or the person making the claim.","Each visit by anurse or therapist is one visit.","You may be billed for any deductiblecopayments, or payment percentage amounts, or any noncovered expenses that you incur.","Policies contain detailed plan descriptions, limitations and exclusions for each type of coverage.","Points are awarded on a quarterly basis via device tracked and synced activity.","Copy and past this code into your website.","The Group Insurance Policy determines the terms and conditions of coverage.","How HMOs work Under an HMO, you must coordinate your care through a primary doctor An HMO, or Health Maintenance Organization, takes a different approach to health care relative to the BP Medical Plan options.","Each facility in the IOEnetwork has been selected to perform only certain types of transplants, based on quality of care and successful clinical outcomes.","Members are responsible for finding care, getting precertification, paying for services provided, and sending in claims for repayment of covered services.","Shorter or longer lengths of stay may be approved by the claims administrator at the request of the attending doctor.","The home delivery program is not available if you live outside the United States.","Inpatient and outpatient expenses directly related to a transplant.","At the time you request FMLA leave, you must agree to make any contributions required by your Employer to continue coverage.","This is the date that will be used to determine timely filing of the application and the due date of the first premium payment.","Intensive or special care facilities.","This will help us coordinate claims and medical management.","This applies even if you or your dependents are eligible for benefits based on a disability continuation provision because you or they are totally disabled.","Affidavit used when you marry or form domestic partnership.","The following two conditions must be met and are subject to applicable law and your plan documents: The child is not able to earn their own living because of mental illness or physical handicap.","OOA Option Office visit copays.","These guidelines apply unless your company has requested a special dependent age extension or other contract change, or unless state law mandates otherwise.","If the Plan requires you to obtain advance approval of a nonurgent service, supply or procedure before a benefit will be payable, a request for advance approval is considered a preservice claim.","VUMC health plan coverage.","We encourage you to use another modern web browser when visiting our site, for example, Google Chrome, Microsoft Edge, or Mozilla Firefox.","It focuses on preventing illness and disability.","Does not meet all of the requirements above, but does meet the requirements of the jurisdiction in which it operates for licensing as a hospital and is accredited as a hospital by the Joint Commission on the Accreditation of Healthcare Organizations.","Triad number: The number for the service center assigned to your account.","Covered expenses do not apply to the plan year deductible or outpocket maximum, and covered expenses do not apply to the plan year deductible or outpocket maximum.","This applies only to the amount of the benefit that was paid by the employer.","You can also choose the types of coverage for which the permission applies.","Information and guidance regarding benefits for Temporaries in benefit eligible assignments while actively employed with the City of Seattle.","Skilled nursing servicesthat require medical training of, and are provided by, a licensed nursing professional within the scope of his or her license.","Welcome to your updated online benefits experience!","Remember, though, that you must be enrolled in a high deductible medical plan, not be claimed as a tax dependent by someone else and not be enrolled in Medicare to make contributions to your HSA.","Any contributions made cannot be refunded.","An urgent admission is a hospitaladmission by a physiciandue to the onset of or change in an illness; the diagnosis of an illness; or an injury.","The last day of the month preceding the month in which the covered person first becomes entitled to Medicare during the COBRA coverage period.","However, Aetnahas the right to pay any health benefits to the service provider.","Please read the details of the plans carefully to understand the benefits provided.","We urge you to consult your legal counsel about your responsibilities for continuation under state laws.","Note: Premiums for new employees who are enrolled off cycle of the policy month will not be charged until the first full policy month of enrollment as Aetna does not prorate premiums.","The box that describes the qualifying event making the beneficiary eligible for COBRA.","Benefits Payable The weekly benefit is based on your predisability earnings, up to the maximum weekly benefit shown in the Schedule of Benefits.","Complete the Health Questionnaire.","Penalties for noncompliance with precertification provisions.","Take advantage of discounted rates and compare home, renters and auto insurance carriers on one platform.","If you answered yes to all three questions, you must have health coverage according to Massachusetts laws.","ID card so the pharmacist knows you are covered under the program.","If you are eligible for Medicare, the plan coordinates the benefits it pays with the benefits that Medicarepays.","This also applies to any increase in your coverage for the two years that follow the effective date of that increase, if Evidence of Good Health was required in order for the increase to take effect.","Keep in mind that most providers will require you to come into their office for a visit to diagnose your disability, and some may charge an additional fee to complete the form.","You can also receive these through the mail order program.","Your message has been sent successfully.","Residential treatment facility care.","If you continue to use this website, you are consenting to our policy and for your web browser to receive cookies from our website.","In general, the program offers prescription drug benefits two ways: For shortterm prescriptions, you must fill your prescription at any Express Scripts network retail pharmacy, unless one is not available in the area.","Follow the procedure chosen by your Employer to report a disability claim to Aetna.","FMLA eligibility and approval ismanaged by Aetna.","We know you and your family have different personal and financial health needs at different stages in life.","All, Frozen Embryo Transfer, Intrauterine Insemination, Timed Intercourse, and more!","College Savings Plan, and more!","Services or supplies that are appropriate for or consistent with the diagnosis according to accepted medical standards as described in the Covered Benefits section of the plan.","The participant agrees that any legal action or proceeding with respect to this provision may be brought in any court of competent jurisdiction as the plan may elect.","It does not offer legal advice, and cannot guarantee the accuracy or suitability of its content for a particular purpose.","The planthat covers the person other than as a dependent, for example as an employee, member, subscriber or retiree is primary and the planthat covers the person as a dependent is secondary.","Aetna network, and you need to submit a claim, please complete and mail one of the forms below to the address on your ID card.","This applies to the employee as a covered person in a plan of group insurance insured by Aetna.","It may involve artificial methods such as feeding tubes, ventilators or catheters.","In furnishing this information, Aetna is acting on behalf of your Plan Administrator who remains responsible for complying with the ERISA reporting rules and regulations on a timely and accurate basis.","It is in accord with accepted medical practice for the condition of the person.","Medical supplies, drugs and medicines prescribed by a doctor, and lab services provided by or for a home health care agency.","Any extensions of benefits under this plan for disability or pregnancy will not always apply on and after the date of a change to an HMO Plan providing medical coverage.","Eligible employees waiving coverage must complete a waiver.","Fairview also offers a direct pay model called Tuition Assistance for eligible educational institutions.","Keeps a medical record on each patient and child.","You are about to permanently delete this Web Part.","Use the HSA Contribution Coupon to deposit new funds via check.","Niagara discounts and your parking points.","Precertification is required for the following services: Inpatient admissions.","The choices you make during this annual enrollment period will become effective the following year.","Health Care Flexible Spending Account.","No need to sure to save your receipts in case you need to validate a claim.","Contact the BP Benefits Center for a domestic partner affidavit for establishment of a domestic partnership before If you already have coverage but are adding an eligible dependent, you may switch BP Medical Program options.","This means your eligible expenses under the Health FSA are restricted to eligible dental and vision expenses only.","Do you offer prescription coverage?","COBRA, or Consolidated Omnibus Budget Reconciliation Act.","Our nurses can give you advice for care at home, or help you decide if you should get urgent or emergency care.","If one of these situations applies, you may enroll before the next annual enrollment period.","Attend a live workshop or complete an online course that interests you.","Many companies offer health care insurance to their employees.","Pregnancy or Parental Leave.","You will enroll online at the time of hire and each year during Open Enrollment.","We may also notify you of changes to our privacy policy by email.","Notices are mailed to Aetna members and are included in standard enrollment packages.","If you participate in Go for the Gold, your Wellness Credit will be applied to your Health Plan Account for Aetna Plus and Aetna Select plans.","You cannot receive multiple coverage under the plan because you are connected with more than one employer.","Because COBRA is directed to employers rather than to carriers, employers have to abide by its mandates and to consult their own legal counsel.","And your premium payments will be waived.","AND check either or both continuation boxes.","You will be responsible forfull payment of the services.","Chase Investment Services Corp.","Pay particular attention to what needs to be included on an enrollment or change form.","Your Bookletincludes the Schedule of Benefitsand any amendments.","In many cases, the inquiry will resolve your issue.","Expenses for diabetic insulin pumps and tubing.","Offers the flexibility to choose your doctor or health care facility when you need health care.","Estimate of Other Income Benefits Aetna will estimate other income benefits for which you appear to be eligible, unless you sign and return a reimbursement agreement to Aetna.","Sync Devicefrom the option on the bottom navigation.","By accepting such benefits, hereby submit to each such jurisdiction, waiving whatever rights may correspond by reason of your present or future domicile.","Aetna has in its files about you.","These guidelines will help you determine when someone is eligible for Medicare primary health coverage.","You must meet the plan year deductible before the plan starts to pay most expenses, including those for formulary brand preventive and nonpreventive prescription drugs.","Under the COB provision of hislan, the amount normally reimbursed for covered benefits or expenses under hislanis reduced to take into account payments made by other plans.","From hospitalto home or to another facility when other means of transportation would be considered unsafe due to your medical condition.","Detoxification and maintenance care are not effective treatment.","For information on how to select a primary care provider, and for a list of the participating primary care providers, contact your Employer or, if you are a current member, your Aetna contact number on the back of your ID card.","All coverage under the Medical Program is based on the truthfulness of statements made by you and your dependents.","With respect to coverage under Medicaid or an SCHIP Plan, you or your dependents no longer qualify for such coverage; orou or your dependents have reached the lifetime maximum of another Plan for all benefits under that Plan.","This applies whether or not the circumstances are the same.","This will not apply to conditions excluded from coverage on the date of the loss.","But since each qualified beneficiary is entitled to elect continuation coverage, the covered employee or spouse may not decline coverage on behalf of another qualified beneficiary.","Aetnawill directly pay the networkproviderless anycost sharing required by you.","Your matching contributions will not be vested until your third year of employment.","Refers to pharmacy plans covering eligible prescription drugs listed on a Preferred Drug List.","Ask your doctor or other health care professional if you need to submit a claim.","On the date of the qualifying status change.","If you think you may qualify for transition coverage benefits, you should call Aetna Member Services to request a review of your situation.","Employees must provide sufficient information for the employer to determine if the leave may qualify for FMLA protection and the anticipated timing and duration of the leave.","United States Preventive Services Task Force as a requirement for coverage.","Affordable Care Act regulations prohibit a group health plan, regardless of grandfathered status, from rescinding coverage for any individual covered under the plan with a few limited exceptions.","If a claimant worked a half day or more, then the DLW is that day.","You will need to report any new dependents by completing a change form, which is available from your employer.","In the event of a misstatement of any fact affecting your coverage under this plan, the true facts will be used to determine the coverage in force.","This plan costs less per paycheck than for other medical options in exchange for having a higher deductible amount.","Provides infirmarylevel medical services.","To get the most out of Fill, please switch to a free modern browser such as Google Chome or Safari.","Mobile menu for the website.","Injury due to a military action, unless the injury results from being an innocent bystander in the situation.","Act, there is no service requirement, all full time and part time employees are eligible.","Claim forms may be obtained from Aetna.","An institution or a part of an institution that is licensed or approved under state or local law to provide skilled nursing care and related services as a Skilled Nursing Facility, extended care facility or nursing care facility.","Medical expenses do not apply to the deductibles under the Prescription Drug Program and vice versa.","You can read about those in the late enrollees section.","Eligible dependents include your: Spouse, including a legally separated spouse.","Fields are being added to your document to make it really easy to fill, send and sign this PDF.","Treat a fracture, dislocation, or wound.","You can enroll: When you first become eligible.","Instructions on how to contact your claims administrator are provided on your medical option ID card.","Coverage period: The time period for which you are being billed for coverage.","If it is a verbal order, it must promptly be put in writing by the pharmacy.","Limit of one single or group adoption reimbursed per calendar year.","Unless you are legally incapacitated, late claims will not be covered if they are filed more than one year after the deadline.","See the HSA Quick Reference for details on how to manage your account online.","Coinsurance refers to the portion of a covered expense that you pay after you have met the deductible.","Medicare is the primary plan and the BP Medical Plan is the secondary plan, as long as no tertiary plan is involved.","Not all disability services are covered.","When calculating the benefit payable, other income benefits that you, your spouse, your children or your dependents are eligible for because of your disability or retirement are taken into consideration.","An inclusive term for the family of disability and absence management products and services.","PPO Option network providers, you may enroll yourself and all your eligible dependents in the OOA Option by calling the BP Benefits Center.","Employers do match these contributions, which vary from employer to employer.","No one, including your employer or any other person, may fire you or discriminate against you in any way to prevent you from obtaining benefits under the plan or exercising your rights under ERISA.","Aetna Rx Home Delivery, LLC, is a subsidiary of Aetna Inc.","Services for Infusion Therapy.","Notice of the change shall be provided in accordance with applicable state law.","Aetnaagrees with the Employerto provide administrative services in accordance with the conditions, rights, and privilegesas set forth in this Booklet.","Speech therapy for treatment of delays in speech development, except as specifically provided in the What the Medical Plan Covers Section.","We recommend making a copy of your form for your records.","Your employer will advise you of the required amount of your contributions and will deduct your contributions from your pay.","The claims administrator also has the right to examine your child as often as needed while the disability continues, at its own expense.","The date BP stops providing group health benefits.","IRS dependents may be taxable to the employee.","COBRA beneficiaries under the group plan.","Google, Android, and Google Play are trademarks of Google Inc.","You should consult a tax advisor for any tax issues related to the HSA.","SSN of each subscriber.","Medicare for their primary coverage.","The date you are no longer under the regular care of a physician.","The Aetna Medicare Supplement Plan coordinates payments with Medicare Part A and B and supplements the Medicare coverage by paying additional amounts not covered.","Dependent children of your domestic partner.","Total payments received since last invoice: The total of payments received since the last invoice.","Savings PPO Option, you must meet your medical plan deductible before you receive plan coverage for all formulary brand preventive prescriptions and all nonpreventive prescriptions.","Aetna and receive a decision on that appeal before the termination or reduction takes effect.","You must furnish true and correct information as Aetna may reasonably request.","This assignment allows the plan to pursue any claim you may have, whether or not you choose to pursue the claim.","The absence of aperson to perform a nonskilled or custodial careservice does not cause the service to become covered.","In Florida, by Aetna Health Inc.","There are government schemes, including Medicare and Medicaid services, but even under these the patient will have to make some form of financial contribution.","Language services can be provided by calling the number on your member ID card.","The amount of money paid to the beneficiary if the insured dies.","If the Medical Program is terminated, your contributions will end as of the last pay period before the programs termination date.","The program is completely voluntary and confidential.","Certificate includes the Schedule of Benefits and any amendments or riders.","You will need Adobe Reader to view and print PDF documents.","Once you enter an eligible class, you will need to complete the probationary period before your coverage under this plan begins.","You can work with your People departmentrepresentative to make payment arrangementfor your portion of your benefits.","While the BP Medical Plan provides benefits for many medical services, some services are not covered.","Under ERISA there are steps you can take to enforce the above rights.","The Prescription Drug Program is administered by Express Scripts, Inc.","To avoid penalties, make sure to contribute less than the legal limits, or withdraw any excess contributions and interest on those contributions before the taxfiling deadline.","By probation period, we mean the period of time before a new employee can join the group plan.","The date the qualifying status change occurs.","Evidence of insurability means the employee must complete an individual health statement and may have to submit medical evidence, via medical records, at their expense.","The services are not custodial.","The child must depend chiefly on the employee for support and maintenance.","Advocacy team members work with you and the claims administrator to understand, research and resolve claims issues.","When you see an outnetwork provider for a covered expense, you typically pay a larger share of the cost.","Treatment of Mental Disorders and Substance Abuse.","Vanderbilt University Medical Center Retirement Plan.","We use these images to identify our users and user behavior, such as counting the number of users who have visited a web page or acted upon one of our email digests.","OOA Options: Aetna uses the charge Aetna determines to be the usual charge level made for it in the Geographic Area where it was furnished.","In that event, only the amount of the income increase will be taken into consideration for the benefit adjustment.","Certificate is issued and whose insurance is in force under the terms of this group insurance policy.","Efforts to maintain quality benefits at reasonable costs are ongoing and will continue to be a primary concern of Shelby County Government.","If you are separated or divorced and your children are covered by more than one group health plan: The plan of the natural parent with custody is the primary plan.","See Handicapped Dependent Childrenformore information.","You may contact ESI to determine your remaining deductible.","That is because these forms need advance approval by Aetna and to be filed with the appropriate regulatory authority in the state the business is written.","Includes meetings at least twice a month with organizations devoted to the treatment of alcoholism or drug abuse.","The number of entries displayed in this section may vary.","Deductions are taken retroactively to the effective date of your coverage as long as you timely enroll.","The pharmacy directory contains a list of local participating pharmacies.","Updated EBS Portal references.","The ARAG Legal Plan offers you easy access to qualified attorneys in your area.","Treatment to correct a speech problem present from birth, or caused by disease, injury or earlier medical treatment.","Instead, your additional service will be used to calculate whatever new subsidy might apply.","Get access to great programs like Progyny, Tuition and Veterinary discounts, and more.","Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.","Your contributions will be taken on an aftertax basis rather than a beforetax basis.","Help set coverage goals that are right for you.","The University provides access to dental coverage for eligible employees.","This is provided the child has not been issued an individual insurance policy.","New topics are released quarterly.","Programs or services that can help maintain good health, such as annual physical exams, or are meant to detect early signs of health problems or disease, such as mammograms and colon cancer screenings.","You pay your applicable prescription drug copay after you satisfy the medical plan deductible.","Take a minute and get to know us?","For a complete list of eligible expenses, go to or Examples of expenses that do not qualify include most cosmetic surgery, health club dues, maternity clothing, and toiletries.","Valid waivers differ by state.","Find help for emotional and mental health conditions.","Each session includes three actions: reading a short, informative article; completing a fun activity; and picking and tracking a wellbeing goal for a month.","Make sure the properties contain information that is safe for others to read.","Health Advocate representative will research the service you need and provide a personalized report.","It meets any applicable licensing standards established by the jurisdiction in which it is located.","Department of Labor, or you may file suit in a federal court in Harris County, Texas.","They can change this assignment at any time.","Services forphysical, occupational and speech therapy.","We have the right to determine the amount and duration of any waiver, reduction, coupon, or financial incentive and to limit the covered persons to whom these arrangements are available.","It must be approved by the appropriate industry organizations.","All of this is described in this handbook.","You have separate payment limitsfor network and outnetwork benefits.","Not the right email?","In case of an emergency, or when traveling, you may need to use a pharmacy that is not in our network.","The earnings you make on your investment are taxfree.","Therefore, you do not need to enroll in a Medicare Part D plan while you are covered under one of these options.","Applicants now have the option to test from home.","Disability insurance is provided to you at no cost.","University support staff with appointments of nine months or more.","BP contribution into your HSA account!","You must meet the annual deductible before the plan will share in the cost of benefits.","BP Medical Plan is required by law to maintain the privacy and security of your personally identifiable health information.","The act or event must be definite as to time and place.","CVS Health, referrals are one of the best ways to get your foot in the door.","The filing of a claim will have no effect on your rights to any other benefits under the Medical Plan.","You can use the same contact informationaboveto report your leave.","This law also provides certain rights for members of the military and their families.","You apply for individual coverage in a jurisdiction where Aetnacannot issue or deliver an individual conversion policy.","The period for which disability is certified.","Please note that any contributions made to your HSA by the plan for completing and returning the physician certification form count toward the maximum amount which can be contributed to your HSA during the year.","Relocation Center to get inside information on a community.","It provides partial reimbursement of membership fees to Medical Center employees who join the Vanderbilt Recreation and Wellness Center.","ERO must notify you, the Claims Administrator and the Medical Plan.","Employees, their spouses and children undergoing dental and orthodontia treatments at the convenient St.","Form used to request prescriptions through mail order.","Notify your manager and the People department as soon as you know you will need a leave ofabsenceand provide tentative dates of your absence.","The primary planpays first without regard to the possibility that another planmay cover some expenses.","Primary doctors are: Family practitioners.","Provides, at all times, skilled nursing servicesby licensed nurses who are supervised by a fulltime Prepares and maintains a written plan of treatment for each patient based on medical, psychological and social needs.","This includes reviews by physicianswho do not own or direct the facility.","UPoint user ID and password, then click on the Flexible Spending Account tile.","The date COBRA will be exhausted.","If you: Live in an HMO Plan enrollment area and choose to change coverage during an open enrollment period, coverage will take effect on the group contract anniversary date after the open enrollment period.","If you are in an eligible class and are covered under an HMO Plan, you can choose to change to coverage for yourself and your covered dependents under this plan.","If you are required to submit evidence of good health, you must furnish all such evidence at your own expense.","Eligible charges from participating NAP hospitals and doctors under the OOA Options.","Once you have been treated and discharged, you should contact your physicianforany necessary followup care.","Claims that are not covered by the plan.","Please log in to your secure account to get what you need.","ID, or other identifying information shown on the front of the Explanation of Benefits form, and any other comments, documents, records and other information you would like to have considered, whether or notsubmitted in connection with the initial claim.","If a participant fails to respond timely to a request for information or materials, the plan administrator may take action, including but not limited to, increasing the participants cost for dependent coverage or terminating the s coverage.","Download the Anthem Engage app to your personal device today.","Just swipe the card at the point of service for eligible health care expenses, and the funds will be taken directly from your account.","The OOA Options also include the Prescription Drug Program, administered by Express Scripts, Inc.","You pay the first portion of recognized charges for most covered expenses incurred by you and each covered dependent during the plan year before the plan begins paying benefits.","Your cost may vary based on the plan option in which you enroll.","Coverage for You and Your Dependents.","Charges above recognized charge limits.","The plan does notcover private duty nursing services as part of an inpatient hospitalstay.","That the person has sent Aetna copies of documents showing the effective dates and amounts of other income benefits.","Some types of compensation, such as commissions, are included or excluded depending on the policy.","Please note the following, which would apply upon your subsequent retirement.","These periods may be a quarter year, a calendar year or contract year.","BP Medical Program coverage.","Be sure to select rather than when you use your card, because the card does not have a separate PIN.","Because the end of the extension period is unknown at this time, please do not delay in submitting your claim or appeal.","Meets any and all applicable licensing standards established by the jurisdiction in which it is located.","Aetna does not provide legal services and makes no representations or warranties as to the quality of the information on the ARAG website, the services of ARAG or of any attorney in the ARAG network.","We do not disclose personal information for these marketing purposes unless the member consents.","You are required to submit a claim to Aetna in writing.","Please refer to the date at the top of this page to determine when this Policy was last revised.","Do not use nicknames.","Contact the medical claims administrator at the number on your ID card for further details about medical necessity and coverage criteria.","If your physicianrecommends that your staybe extended, additional days will need to be certified.","In some instances, Fairview pays you a wage while you complete training.","Insurance policy terms that define who is eligible to get coverage and the requirements for receiving coverage.","The formulary is developed and maintained by Express Scripts and is available online or a paper copy may be requested.","Savings PPO Option, there is no separate plan year deductible for prescription drugs.","Copayment is the fixed dollar amount an employee pays when they visit the pharmacy or doctor.","Discount Program: The member discount program includes discounts on services such as vision services and hardware, fitness, and hearing aids.","Does not have a place for patients to stayovernight.","You can begin contributing to this program immediately.","There may be times, however, where we are not able to fulfill your request, for example, if applicable law prohibits our compliance.","Products not available in all states.","They are subject to the contraceptive counseling services visit maximum shown in yourcheduleenefits.","The VUMC Health Plan encourages employees to use the VUMC pharmacies, where you will get the best price for prescriptions.","BP Corporation North America Inc.","The credit can be applied to other covered members on your health plan, including your spouse and dependents.","Any covered expensesyou incur from an IOEfacility will be considered network care expenses.","Change all dependent information, including Social Security number or Medicareeligibility status.","Network The amount you owe for health services before your health insurance begins to pay.","Hospitalservices and supplies received for a stayrequired because of your condition.","Coverage may end if premium payments are not made in a timely manner.","Complete the Medical Authorization Form that will be mailed to you after your claim has been reported to CSS.","Aetna has the right to examine and evaluate you at any reasonable time while your claim is pending or payable.","This applies only if a physician agrees that such changes, adaptive devices or equipment suit your particular medical limitations.","It may vary depending on the insured product.","If an MCSO is determined to be qualified, coverage will be subject to the terms of the QMCSO guidelines issued by the plan administrator from time to time.","Accordingly, these voluntary insurance programs are not subject to ERISA and related regulations.","You can also take advantage of the Vanderbilt Mail Order Pharmacy, meaning your medications will be shipped for free.","He or she depends chiefly on you for support and maintenance.","The availability of a plan or program may vary by geographic service area and by plan design.","Admissions to a skilled nursing facilitymust be precertifiedby Aetna.","Aetna reserves the right to use a comparable index.","The partial hospitalizationwill only be covered if you would need inpatient care if you were not admitted to this type of facility.","The types of services offered will vary by the provider and location of the clinic.","These devices are necessary because the body part is permanently damaged, missing or not working properly.","Log in to Producer World.","This coverage does not extend the maximum coverage period under COBRA.","If your dependents live away from home To determine whether your dependents will be able to access the PPO network providers, you must call the Aetna Member Services Center.","Contact the HMO directly for more information.","An amount of money that a member must pay for covered services, including prescription drugs, in a specified time period, before the plan will pay benefits.","We offer this functionality to help generate interest in our Website and content and to permit you to recommend content to your contacts.","If your claim involves urgent care, an expedited appeal may be initiated by a telephone call to the phone number included in your denial, or to the claims administrators Member Services, which number is on your Identification Card.","It is therefore important to remind the provider to submit the claim to Aetna directly before you pay.","BP Medical Plan will not pay any benefits if the primary plans benefits are in all cases equal to or better than the BP Medical Plans benefits.","You will be responsible for the unpaid balance of the bills.","Refer to How the Plan Worksfor details about precertification In addition to charges made by the hospital, certain physiciansand other providers may bill you separately during your stay.","Prescription drug service for pharmacy members, who receive medications by mail.","This includes, but is not limited to, refraining from making any settlement or recovery that attempts to reduce or exclude the full cost of all benefits provided by the plan.","Your updated vesting schedule may take up to four weeks to appear in your Morgan Stanley account.","Another that you can send to the home delivery program for an additional supply.","These include, but are not limited to: sitter or companion services for either you or other family members; transportation; maintenance of the house.","Progyny to offer an Adoption Assistance benefit to help make starting your family a little bit easier.","Effective after successfully completing your introductory period.","Your short term disability benefits will be payable for as long as your disability benefit eligibility continues but not beyond the end of the maximum weekly benefit period.","Prescription drugs Provider files claims.","If both parents have the same birthday, the planthat covered either of the parents longer is primary.","What was the make of your first car?","Coverage under the Medicare Advantage Plan means you still have Medicare, but your insurance coverage is managed and paid for by Aetna.","You have unique needs when it comes to your health, this is why The University of Chicago has chosen to offer you the choice of two medical plans, both administered by Aetna: the Medicare Advantage Plan or the Medicare Supplement Plan.","Orthoptic or visual training or visual therapy.","Aetna health insurance plan policy.","The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.","Aetna Aetna Life Insurance Company, an affiliate, or a third party vendor under contract with Aetna.","Go to a network pharmacy.","Final Internal Adverse Benefit Determination concerns an admission, availability of care, continued stay, or health care item or service for which you received emergency services, but have not been discharged from a facility.","Savings Options are based on recognized charge limits.","When during a covered inpatient stayhospitalskilledingfacilityor acute rehabilitation hospital, an ambulanceis required to safely and adequately transport you to or from inpatient or outpatient medicallynecessarytreatment.","If the information provided matches our records, you will receive an email containing your new password shortly.","Comply with our legal and regulatory responsibilities and to enforce our rights.","BP Retiree Medical Plan.","If you choose to participate in the wellbeing program, you will have the opportunity to complete the Health Questionnaire.","You are now being directed to the Apple.","Visit the What Is Different?","If both parents have the same birthday, the plan that has had coverage in effect longer is the primary plan.","Requires group health plans to provide certain benefits regarding a mastectomy and to provide their plan participants notice of their rights with regard to mastectomies.","The date you fail to provide proof that you meet the short term disability test of disability.","For coverage purposes, followup care is treated as any otherexpense for illnessor injury.","Any manual or systematic adjustments that are processed to the account.","You have the right to designate any PCP who participates in the HMOs network and who is available to accept you or your family members.","You may also request that the claims administrator provide you, free of charge, copies of all documents, records and other information relevant to the claim.","For an emergency outpatient medical condition: You or your physician should call prior to the outpatient care, treatment or procedure if possible; or as soon as reasonably possible.","Predisability Earnings The amount of salary or wages you were receiving from an employer participating in this Plan on the day before a period of disability started, calculated on a weekly basis.","Expenses associated with a nurse or other person assisting in surgery who is not a medical doctor, and expenses associated with an assistant surgeon if the claims administrator determines that a second doctor is not medically necessary.","The claims administrator for an HMO option is the HMO.","It is your responsibility to understand the terms and conditions in this Booklet.","Fairview provides all employees with professional liability insurance.","Obtain, upon written request to the BP Benefits Center, copies of governing plan documents.","BPs employment practices are determined without regard to the benefits offered as part of your total compensation package.","Coverage is available regardless of their student, marital or tax dependent status and regardless of their access to another employer sponsored group plan.","Services or supplies provided to a minor or dependent adult when a family member or caregiver is not present.","For more information, go to www.","Open Enrollment are subject to EOI.","Recipients are selected based on academic performance, school and community involvement, statement of academic and career goals, and more.","It lets the insured collect a regular pension at retirement, without penalty for the period of disability.","If you are hired or enter an eligible class after the effective date of this plan, your coverage eligibility date is the date you complete the probationary period.","Expenses under the Prescription Drug Program.","It also may explain the claims appeal process and provide other information.","The services have to be performed by: A licensed or certified physical, occupational or speech therapist.","When you go to an outnetworkprovider, it is your responsibility to obtain precertificationfrom Aetnafor any services or supplies on the precertificationlist below.","The site provides you with streamlined investment choices and online tools to help you with your retirement planning and decision making.","Services are offered through vendors which are not affiliated with The Hartford and these services are not insurance.","More information about each of these features is outlined in this section.","Only available to employees in specific locations.","The term applies only to the determination by the plan whether health care services are covered benefits.","Within one business day after completion of the preliminary review, the Claims Administrator must issue to you a notification in writing.","Aetna will have the right and opportunity to have a physician of its choice examine any person who is requesting certification or benefits for new and ongoing claims.","See Medical Plan Exclusions for more information.","Has a fulltime administrator.","This can also help lower your costs and keep you healthy.","As long as the service provided is covered, you will not have to pay the provider upfront and then look for reimbursement.","By continuing to use our Website and Services following such changes, you will be deemed to have agreed to such changes.","The Policyholder selects the products and benefit levels under the plan.","What Is a Qualifying Life Event?","That benefits have been denied after review at the highest administrative level.","The only proper venue for a lawsuit seeking enforcement of your rights under this plan is in federal court in Harris County, Texas.","Rates vary by area.","Learn researchbased ways to maximize your sleep and become a healthier you.","The services require medical or paramedical training.","Home ovulation prediction kits or home pregnancy tests; vulation induction and intrauterine insemination services if you are not infertile.","Complex Imaging Expenses for preoperative testing will be payable under this benefit.","Invoice number: Unique to every bill.","All eligible expenses will be reimbursed as long as they were incurred during the period you were covered under the BP Medical Program.","Specialty drug coverage is administered by Accredo.","Participation in Amazon benefits does not signify a contract of employment.","Persons with hearing or speech disabilities may contact us via their preferred Telecommunication Relay Service.","If you elect account.","The standard levels of appeal have been exhausted; or The appeal relates to a rescission, defined as a cancellation or discontinuance of coverage which has retroactive effect.","Assistance with Your Questions If you have any questions about your Plan, you should contact the Plan Administrator.","At times, you may notice terms or references that do not apply to your plan.","Discount programs for a variety of recreational activities and much more!","The applicable contribution percentage for coverage applies whether you choose coverage for yourself only or you and your dependents.","Banner and Aetna and its affiliates are not responsible for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.","HMO premium has been paid.","Coverage may begin on the first day of employment.","See How HMOs work A summary of options available to you is on BP Benefits Center online.","If so, Aetnamay pay that amount to the organization, which made that payment.","It will help you make maximum use of your benefits.","This establishes an order in which the plans pay their benefits.","Privacy Practices describes our privacy policy.","The Health Plan Account helps you pay your deductibles and coinsurance.","Allclaims should be reported promptly.","Limitations and exclusions apply.","You will be responsible for your paymentpercentageup to the maximumoutpocketlimitapplicable to your plan.","The day after Aetna determines that you can participate in an approved rehabilitation program and you refuse to do so.","Federal Social Security benefits.","This is actually a bookkeeping entry, and there is no vested ownership in such entries by any participant.","When a claim is made, the primary plan pays its benefits without any consideration to the secondary or tertiary plans.","Thereafter, you will be contacted by Human Resources annually to verify eligibility.","This Web Part Page has been personalized.","Preparing to Leave the Nest: Tips for Young Adults and Parents.","Aetna does not endorse any vendor, product or service associated with these programs.","Consolidated Welfare Benefit Plan is funded by and participating employerscontributions and by investment earnings.","Others are standard features of your Aetna group plan.","You should discuss your leave plan with your manager, but how and when you utilize your leave is at your discretion.","If you are injured at work.","Each main plan type has more than one subtype.","Of course, this applies only if you keep making premium payments to Aetna on behalf of the employee.","HMO will not cover that care.","Check with your Peopledepartment to confirm eligibility.","You must complete all of the levels of standard appeal described above before you can request External Review, other than in a case of Deemed Exhaustion.","An act or event must be definite as to time and place.","Aetnaonline provider directory at www.","Employer determines the approved FMLA leave is terminated, any Conversion Privilege will be available on the same terms as though your employment had terminated on the date your Employer determines the approved FMLA leave is terminated.","An injectable drug prescribed to be selfadministered or administered by any other person except one who is acting within his or her capacity as a paid healthcare professional.","You cannot receive multiple coverage under this plan because you are connected with more than one Policyholder.","The prescription drug benefit is through CVS Caremark.","The date this plan no longer allows coverage for domestic partners.","You should keep track of your contributions to ensure you dont exceed these limits.","Certificate if the disability starts on or after the effective date of the plan modification, but prior to your receipt of amended plan documents.","The removal of plaque and calculus from the area below the gum line, along the root.","All questions or claims regarding these programs should be directed to the insurer.","Make changes to your current coverage based on qualifying status changes or relocation.","Your needs are unique to you, so Citi provides you with different medical options from which to choose.","The OOA Options are available only if you live in an area where the Aetna Choice POS II network is not available.","Termination of Dependent Coverage as to your child for any reason other than reaching the maximum age under your plan.","The treatment can be a part of care after a disease, illness, injury or operation.","Refers to specific pharmacy benefits plans that cover all eligible prescription drugs.","They are not covered under most standard prescription benefits plans.","An injury or disease resulting from performing a job.","Manage my personal policy, bills and claims.","Once this is completed, youreceive a confidential online health report with tips to improve your health.","Talk with your People department representative to determine eligibility.","The PPO Options give you a choice when it comes to getting medical care.","In that event, you should provide your Employer a completed and signed Declaration of Termination of Domestic Partnership.","In addition, this is an eligible dependent for whom the employee did not elect coverage within the Initial Enrollment Period, but for whom coverage is elected at a later time.","You and your physicianwill receive a notification of an approval or denial.","Salaries are equitable and consistent, based on relative internal equity and worth.","You have successfully saved this page as a bookmark.","Tests and procedures ordered by a health care professional to determine if a person has a specific condition or disease based on signs or symptoms.","Applied Behavioral Analysis, the LEAP, TEACCH, Denver and Rutgers programs.","Expenses under the Prescription Drug Charges above the recognized charge limits.","If you file a formal claim with ERISA Claims and Appeals on behalf of the claims administrator, it will be reviewed subject to the same timeframes applicable to formal claims for benefits.","Some states, however, require that managed care organizations assign a PCP to members who do not select one at enrollment.","BP Retiree Medical Plan to one who did not, and you met the eligibility requirements for the BP Retiree Medical Plan while at the participating employer, your notional RRA balance will be frozen at the time of transfer.","Certificate, or other activities, as permitted by applicable law.","ERISAs deadlines on an interim basis for participants or beneficiaries to pursue benefit claims and appeals.","Opening balance: The balance due from earlier months.","This Plan will pay for all of the services and supplies, approved in advance by Aetna, you need in connection with participation in the program, except those for which you can be reimbursed by another payer, including government benefits programs.","As well, this may render some of the contributions to your HSA taxable.","For additional information about benefits for covered preventive care services, contact the member services number on your medical ID card.","You must also provide Aetna with authorizations to allow it to investigate your claim and your eligibility for and the amount of work earnings and other income benefits.","President of the United States.","Please refer to the Schedule of Benefitsfor specific plan details.","However, you will pay the entire cost of retiree medical coverage for yourself and your eligible dependents.","Your outpocket maximum calculations will reflect your copay amount and not include any financial assistance provided to you by manufacturers of your medications.","Plan, have a duty to do so prudently and in your interest and that of other plan participants and beneficiaries.","To complete the enrollment process, you will need to provide all requested information including any evidence of good health.","In this case, the following special rules apply.","Network expenses do not count toward meeting the outnetwork medical deductible.","Occurs after a person has met the benefit Elimination Period and qualified for disability benefits under the plan.","If you do not enroll during this time, you will need to wait until the next annual enrollment period.","To continue, please close this message or navigate using the links above.","You must submit a completed claim form and proof of payment to Aetna.","Seek help for work or personal concerns including stress, anxiety, depression, relationship issues, and more.","Doctor, surgeon and related professional fees.","Networkproviderswill be responsible for obtaining necessary precertificationfor you.","Aetna International website, which may differ from the terms and conditions of www.","Much of the information on the site is also available in Spanish.","If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court.","Each year the IRS determines the annual maximum you can save toward retirement.","Human Resources is located on the third floor of the Cambridge Office Building on the Rice campus.","Employees can choose between two plans.","Any of these other income payments that date back to a prior date may be allocated on a retroactive basis.","Expenses incurred for one transplant during these four phases of care will be considered one transplant occurrence.","Headspace must be connected to your Apple Healthkit or Google Healthkit in order for your activity to be tracked automatically on this site.","You will not have to submit medical claims for treatment received from networkproviders.","If you or one of your covered family members could be a potential transplant candidate, contact the claims administrator to learn more about this program.","Savings PPO Options, you will pay lower office visit copays for network providers who are considered primary doctors than for those who are considered specialists.","These procedures can be performed in the hospital, a surgery center or physician office.","Aetna for certain specialists who have met certain levels of clinical performance and efficiency.","Coverage for a handicapped child may be continued past the age limits shown above.","Custodial carecan be prescribed physicianor given by trained medical personnel.","Find out which network providers are located near your home or work.","It requires that certain employers allow eligible employees access to unpaid time off for specific family and medical reasons.","We suggest you enroll employees as soon as they are hired to avoid being late.","Having a primary doctor is the first step in maintaining better health and saving on health care costs.","If you do not intend to leave our site, close this message.","PCP based on where they live.","Any doctor, hospital, skilled nursing facility, other individual or entity involved in the delivery of health care or related services that contracts to provide covered services to members for a negotiated charge.","These individual plans are known as conversion plans.","See plan documents for a complete description of coverage.","Employees may select either an Individual membership, a membership for self and one legal dependent, or a Family membership.","Read your Schedule of Benefitscarefully to understand the cost sharing charges applicable to you.","Once the infection is treated the empty canals are filled with an inert, or inactive, material, with the goal of eliminating the need for extraction.","Services provided by a spouse, domestic partner, parent, child, stepchild, brother, sister, inlaw or any household member.","Learning Center to access lessons to improve your mental and physical health, and relationships at work and at home.","If you have diabetes, you may be eligible to participate in Livongo for Diabetes, a health benefit that makes living with diabetes easier at no cost to you.","By continuing to browse this website you accept the use of cookies.","Throughout this summary there are references to the BP Medical Program and the BP Medical Plan.","Click here for more information.","You will default into the plan that is closest to your current plan.","If you have questions regarding the amount of your copay, please contact ESI.","HIPAA stands for the Health Insurance Portability and Accountability Act.","Failure to do so could result in a delay in the processing of your claim.","These buttons know that you are logged in to your social network account and therefore such social networks could also know that you are viewing the JD Supra Website.","See Leaving BP for more details.","For forms and information about conversion plans, your employees can contact Member Services.","The date of your death.","Check with your supervisor to determine if you are eligible for shift differential.","See Pregnancy Related Expensesfor information about other covered expensesrelated to maternity care.","Scan your completed form.","The greatest amount of benefits that will be paid under an insurance plan.","They will apply only if the person is not covered at once under the HMO Plan because he or she is in a hospitalnot affiliated with the HMO.","New Jersey late entrants cannot be postponed.","Aetna does not warrant or guarantee and makes no representations as to the quality of services offered by CISC.","BP or a separate Not enrolled in Medicare.","Please refer to the enrollment section of this manual for instructions for terminating coverage.","When it is necessary to group three digit zip codes, the grouping never crosses state lines.","We can assume no responsibility for providing this statement.","If you are enrolled in a Citi medical plan option, you have access to fertility support benefits through Aetna and Anthem.","Has a written agreement with a hospitalin the area for immediate emergency transfer of patients.","We reserve the right to change this Privacy Policy at any time.","Premium: The total premium for single subscribers enrolled in the plan.","Coverage may be terminated, including retroactively, if such statements are found to be false, and intentional falsehoods will be considered a violation of the BP Code of Conduct, subjecting you to disciplinary actions, up to and including termination of employment.","At least one staff physicianmust be on call at all times.","The reimbursement agreement includes your promise to repay Aetna for any overpayment of benefits made to you.","Prescription Drug Program if they: Require a prescription for dispensing; Are FDA indicated for an approved diagnosis; Are medically necessary; and Are not experimental in nature.","This may result in a reduction in benefits payable.","All contributions are made per pay period; you will not receive a Fairview contribution if you do not contribute to your own HSA.","Complete and send the form to Aetnaat the specified address.","Defines the Terms Shown in Bold Type in the Text of This Document.","ID number for the employee and each dependent.","Failure to do so may prohibit them from being issued an individual policy later.","VUMC employees have comprehensive and readily accessible care in all specialties, including behavioral health.","Adverse Benefit Determination will be provided free of charge upon request by you or your authorized representative.","The extension will be for the same length of time and for the same conditions as the HMO Plan provides.","Use Fill to complete blank online EASTERN MICHIGAN UNIVERSITY pdf forms for free.","Complications arise during labor; or A child is born with an abnormality which impairs function or threatens life.","You also are encouraged to share your results or concerns with your own doctor.","Applied Behavioral Analysis is an educational service that is the process of applying interventions: That systematically change behavior; and That are responsible for the observable improvement in behavior.","Two or more periods of absence from work that are related in diagnosis and separated by a time period defined by the contract.","No other plan benefits will pay for nonemergency care in the emergency room.","If the physicianinitially selected cannot accept additional patients, you will be notified and given an opportunity to make another selection.","Any loss of bodily function or capacity.","It is usually an employer or doctor who fills out the majority of the form.","You will need to present documentation, such as a birth, marriage, or death certificate, or divorce decree.","We use persistent cookies when we need to know who you are for more than one browsing session.","Look for your points to be updated each month.","It explains which other income benefits reduce your weekly short term disability benefit.","We will make all practical efforts to respect your wishes.","JD Supra takes reasonable and appropriate precautions to insure that user information is protected from loss, misuse and unauthorized access, disclosure, alteration and destruction.","For example, your employer may provide your information to us, such as in connection with an article submitted by your employer for publication.","Your Policyholder hopes to continue this plan indefinitely but, as with all group plans, this plan may be changed or discontinued with respect to your coverage.","They may not be sent as scanned images via email.","Look at the late enrollees section that follows.","Youll receive confidential support to help you learn to better care for your condition.","Do not wait until you go back to work.","Enrollment changes should be processed via the online enrollment tool.","Each fund has a different investment goal and offers a different level of investment risk and potential return.","Vision Services is the provider for vision care.","Savings option, the lower deductibles apply if you have You Only coverage.","We also use these tools to help deliver reader analytics to our authors to give them insight into their readership and help them to improve their content, so that it is most useful for our users.","Other conditions may meet the definition of continuing treatment.","The Health Plan Account does not apply toward copays.","Disability insurance provides salary continuance in the event that you become disabled and are unable to work.","HMOs are required to designate a PCP for members who do not select one at the time of enrollment.","Employees are given a single point of contact for Leave and Disability who will proactively reach out to guide them through the process and connect them to additional resources to aid their recovery.","It is believed to be accurate at the time of posting and is subject to change.","Establishment of a domestic partnership.","If the current value is empty, set the previous value.","If your claim is denied in whole or in part, you will receive a written notice of the denial from the respective claims administrator.","Savings option, you will also have the opportunity to complete the physician certification form where you will complete a metabolic screening and measure your blood pressure, HDL cholesterol, triglycerides, fasting blood glucose and waist circumference.","You also have the right in certain circumstances to ask us to restrict processing of your personal information or to erase your personal information.","BP has delegated authority to render decisions on benefits and services to these claims administrators.","ERISA or under state law, as applicable.","Medicare program, leaving spouse or dependent children without coverage.","You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.","Generally, the coverage level may be less, and there is an applicable overall lifetime maximum benefit.","Regardless of your age or years of vesting service in a BP retirement plan, your surviving spouse is immediately eligible for coverage under the BP Retiree Medical Plan at the minimum retiree contribution percentage.","End of a domestic partnership.","Initial Report of Disability.","Binding terms and conditions that are applied to insurance plans.","If you believe the plan has violated your privacy rights, you may file a complaint with the plan, the plans Privacy Officer or with the Secretary of Health and Human Services.","To support the career aspirations of our employees and others, Fairview partners with numerous education institutions to provide health care education and training programs.","The numbers are listed below and also on their Aetna ID card.","The enrollment section of this manual has details on terminating coverage.","It can also be done if a benefit is payable to your estate.","External Review process, call the tollfree Customer Services telephone number shown on your ID card.","This will be done at no cost to you.","If you participate in the Standard OOA Option there is a separate prescription drug plan year deductible.","Informed Health Line nurses cannot diagnose, prescribe or give medical advice.","It replaces pension benefits that were unearned because of a disability period.","Police or fire reports from the investigating agency if your death is caused by an accident.","In general, leaves of absence are available to eligible employees for time off due to a qualifying medical condition, or that of a qualified family member.","The disability extension applies only to employee basic and supplemental life insurance.","If you have any questions about the terms of this plan or about the proper payment of benefits, contact your Policyholder or Aetna.","The general rule is that the benefits otherwise payable under this plan for all covered benefits or expenses will be reduced by all other plan benefits payablefor those expenses.","You can request claim forms from the claims administrator or download them from the claims administrators Internet site.","You can find enrollment forms for your state online at www.","Similarly, if an HMO fails to pay its network provider for service you receive, you may be individually liable to pay for such services.","Also refer to Exclusionsfor information about Home and Mobility exclusions.","Amazon partners with Progyny, the leading infertility benefits provider, to provide our employees comprehensive infertility coveage.","Teeth that never existed.","Any continuation will be available on the same terms as those for which employment is terminated.","Refer to the Schedule of Benefitsfor details about any applicable deductibles, payment percentage, benefit maximums and frequency and age limits for physical exams.","Refuse payment or reimbursement for claims incurred by any covered person or other person who has engaged in improper conduct with respect to the BP Corporation North America Inc.","Drugs that can be bought without a prescription.","Connect you to healthcare resources in your community.","If you are using our Website or Services and click a link to another site, you will leave our Website and this Policy will not apply to your use of and activity on those other sites.","If you are traveling outside the country, you are covered for urgent and emergency care.","You are now leaving the Aetna Medicare website.","These health care plans have national provider networks allowing for broad employee and family access.","Please contact your People department regarding enrollment.","It helps cover things like your deductible and coinsurance, transportation and lodging.","Deductible waived for diabetic insulin pumps and tubing.","Voluntary termination of pregnancy.","Savings OOA Option has two separate deductibles.","Before making this change, please see the Medicare section of this manual.","Eligibility starts with the semester beginning three months after your hire date.","Patient has a chronic, degenerative or disabling disease or condition.","Is run by a staff of physicians.","You pay for the actual care you need.","These parties are required to keep personal information confidential as provided by applicable law.","Please refer to the enrollment section of this manual for instructions on terminating coverage.","If the member is entitled to Medicare because of disability, various factors are used to determine the primary payer.","Aetna is proud to be part of the CVS Health family.","Speech therapy to improve speech skills that have not been fully developed or to maintain speech communication.","Policies pay a lump sum benefit for specific serious illnesses.","This means your covered network expenses count only toward meeting the network medical deductible.","Provides, or arranges with a medical facility in the area for, diagnostic xray and lab services needed in connection with surgery.","Control, suffix and account number: Fill in the prior control, suffix and account number.","The Human Resources department of the Catholic Diocese of Dallas provides services to the diocese in the recruitment and training of employees, and in the administration of benefits and compensation.","Your employer may offer Aetna life insurance plans.","You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellbeing program, nor may you be subjected to retaliation if you choose not to participate.","Coverage for your covered dependents ends on the earlier of the following dates: The last day of the month in which your coverage ends.","For more details about medical expenses or behavioral health care covered under the BP Medical Plan, call Aetna.","You are now being directed to the CVS Health site.","You do not need to precertifyservices provided by a networkprovider.","Coverage may be assigned only with the written consent of Aetna.","Internet Explorer, meaning the features of our website may not work correctly for you.","Savings OOA Option, there is no separate plan year deductible for prescription drugs.","COBRA continuation coverage as may otherwise be available.","Insurance at no cost to you.","You are responsible for filing all claim forms.","Bring your medical ID card.","If you have questions, contact Cigna or the BP Benefits Center for more information.","Fidelity and make potentially tax free withdrawals in retirement.","Social Security tax, Medicare tax, federal income tax and, in most areas, state and local income tax.","Expenses not covered by the PPO Option.","Vanguard Target Date Fund with Fidelity.","Form used for Aetna reimbursement claims.","Shield dental plan, you can take advantage of these discount programs.","Only devicetracked minutes will count for points.","Voluntary contributions cannot exceed IRS limits.","Disability insurance plans contain exclusions and limitations.","Coverage for handicapped dependents may continueafter theyreach any limiting age.","App Store is a service mark of Apple Inc.","Medical, Behavioral and Vocational Case Managers help employees return to work safely, swiftly and effectively.","Otherwise, you may be considered a Late Enrollee.","Request for Long Term Disability Conversion Materials.","Our Website and Services may contain links to other websites.","Your dependent is no longer totally disabled, or he or she becomes covered under any other group plan with like benefits.","Some of the group plan provisions that allow for continuation are required by the federal government.","Understanding these terms will also help you understand how your plan works and provide you with useful information regarding your coverage.","The Federal Government is responsible for paying for the vaccine serum.","The claims administrator will have the right to require proof of the continuation of the disability.","Intermittent visits are considered periodic and recurring visits thskilled nurses make to ensure your proper care, which means they are not on site for more than four hours at a time.","Covered as a dependent of another BP employee or retiree in a BPsponsored medical plan.","Emergency and other new conditions may be eligible for a claim.","In addition to the copay, you also pay any charges that exceed recognized charge limits.","New hires living in a new service area may need a new OOS PPO service area and plan set up.","Savings Center to find discounts on namebrand, everyday and luxury items.","Assistance to help your employee navigate and understand health care options, benefits and costs.","You can use the money in your HSA to pay for eligible health care expenses, or you can choose to save your funds for the future.","If you have a disability that requiresa work accommodation, please reach out to your People department.","If, through no fault of your own, you are not able to meet the deadline for filing claim, your claim will still be accepted if you file as soon as possible.","Charges made by a physician for, or in connection with, a surgery that exceeds the following maximum when two or more surgical procedures are performed at one time.","At CVS Health, we are joined in a common purpose: helping people on their path to better health.","In addition to the above: if you must be out of work because you are disabled, a claim for a Short Term Disability Benefit should be made right away.","Customer name and address: The name and address of the customer to which the invoice will be sent.","Assistance to purchase a home on Long Island.","You may also be eligible to continue coverage under COBRA.","Female contraceptives devices that aregeneric devices and brand name devices.","The BP Medical Plan will cover these services both innetwork and outnetwork.","By terminating the plan, you are also forfeiting the prescription benefit.","Fairview offers two dental plan options, both administered by Delta Dental.","This is usually a check or wire transfer number.","ESI will reimburse you for your cost, less the appropriate copay or coinsurance.","Log in to your member portal.","Care provided by Christian Science Sanitariums and Practitioners.","If your plan is not listed, then you should follow the steps below on the enrollment or change form.","Such counselingrvicesreoveredxpeneswhen provided in either a group or individual setting.","Selecting and contracting with a claims administrator and other service providers.","The disability continues throughout the COBRA continuation period.","You can also use your HSA for some health care expenses not covered by your health plan, such as glasses or contact lenses, but such expenses will not count toward your deductible.","Once you no longer meet the short term disability test of disability any new disability will be treated separately.","Reports, evaluations, examinations or hospitalizations not required for health reasons.","In the case of an urgent care claim, a health care professional with knowledge of your condition may always act as your Authorized Representative.","You should discuss your leave plan with your manager, but how you utilize Ramp Back is at your discretion.","In addition, some expenses are payable only within the IOEnetwork.","You may be billed for any deductibleor payment percentageamounts, or any noncovered expenses that you incur.","Certificate becomes your Certificate of Coverage under the Group Insurance Policy, and it replaces and supersedes all certificates describing similar coverage that Aetna previously issued to you.","We also utilize email web beacons to monitor whether our emails are being delivered and read.","Under ERISA, there are steps you can take to enforce these rights.","Print the RRA claim form from the Aetna website.","Enrollment You will be provided with plan benefit and enrollment information when you first become eligible to enroll.","By subscribing to our website, you expressly consent to your information being processed in the United States.","As a result of your membership in, or association with, any group, association, union or other organization.","But since some group plans cover all injuries or diseases, check your plan documents for the specific terms that apply to your group plan.","Life and disability products are underwritten or administered by Aetna Life Insurance Company.","This link will take you to an external web site.","Washington and Lee University is pleased to offer medical insurance through Aetna.","By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice.","If your Employer grants you an approved FMLA leave for a period in excess of the period required by FMLA, any continuation of coverage during that excess period will be determined by your Employer.","Formulary designations may change as new clinical information becomes available.","Pet Assure is not insurance and all pets are eligible, regardless of type, age, breed, or health condition.","When you useoutnetwork providersyou may have to pay for services at the time they are rendered.","When you participate in either option, you will receive a separate ESI prescription drug ID card.","The notice will explain the reason for the denial and the appeal procedures available under the Plan.","You are liable for claims incurred.","Radiological services, laboratory testing and diagnostic services.","Experimental or investigationaldrugs, devices, treatments or procedures, except as described in the What the Plan Coverssection.","Joint Commission on the Accreditation of Healthcare Organizations.","Please see the GBS Medical SPD for more details on transfers between Core and GBS.","CVS Health Jobs: Career opportunities to drive the change that the health care industry is ready for.","Your signature: You as the employer must sign and date the form.","The plan gives you access to tools, tips, programs and services to help you find doctors and estimate costs.","The law requires group health plans that choose to cover mental health and substance abuse services cover those services in parity with medical and surgical services also offered.","When a covered employee or spouse elects to cover any other qualified beneficiary, the other qualified beneficiary is bound by that election.","Otherwise, coverage will begin on the first day you are actively at work.","During annual enrollment, you decide how much to contribute to your HSA on a beforetax basis, up to the IRS limits, which can change annually.","The end of the National Emergency date is currently unknown.","Website and Services, including via email digests and social media feeds, and is accessible to the general public.","There will be no rules for waiting periods or preexisting conditions.","We are experiencing higher than usual call volumes and apologize for any delays you may experience.","Savings OOA Option is available only if you live in an area where the Aetna Choice POS II network is not available.","For certain qualifying events, such as your leaving BP or your reduction in hours causing loss of benefits eligibility, the BP Benefits Center will send COBRA materials, without any required action by you.","Attention Maine and Tennessee Residents: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company.","We may also receive information about you from third party sources.","Attention Ohio Residents: Any person who, with intent to defraud or knowing he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.","The notice may be oral unless you request written notification.","Savings PPO Options Note: If you use either the Westlake or Cherry Point Clinics, you will pay a reduced office visit copay.","They must continue to live within the Aetna HMO service area, however.","Form used to add benefits.","Organ means solid organ; stem cell; bone marrow; and tissue.","If you become terminally ill or suffer from a sever medical condition, you can ask for us to pay a portion of your death benefit in advance.","Your employer will determine the amount of your plan contributions, which you will need to agree to before you can enroll.","Placing your health in serious jeopardy; or Serious impairment to bodily function; or Serious dysfunction of a body part or organ; or In the case of a pregnant woman, serious jeopardy to the health of the fetus.","For BP Participants or surviving spouses with an eligibility event under a heritage retiree medical plan, the rules of the heritage plan apply.","Periodontal disease is a chronic bacterial infection combined with inflammation.","The date your required contribution is received by Aetna.","Weekly benefits for a period less than a week will be prorated.","Medicare provides your primary medical coverage and pays first.","Savings Option to continue contributing to your HSA.","When this plan pays benefits for disabilities incurred due to Third Party Injuries, Aetna shall be subrogated to your right of recovery against any party to the extent of all benefits provided by this plan.","Copies of all bills and receipts.","Ask if your doctor accepts Aetna or Anthem insurance or find one who does.","Leave can be taken intermittently or on a reduced leave schedule when medically necessary.","These may include radiology, ultrasound, nuclear medicine, and laboratory and pathology services or tests.","Medicare Fee Schedule for the Geographic Area where the service is furnished.","Birth date: The employee must list their birth date and the birth dates for all dependents.","Some examples include copayments, deductibles, eyeglasses, hearing aids, and contacts.","Money contributed to FSAs must be used during the plan year.","Investment of your HSA In addition to new contributions, your HSA account can grow through any investment income on your account.","Our integrated customer service team is dedicated to your needs.","Attention New Jersey Residents: Any person who includes any false or misleading information on an application for an insurance policy or knowingly files a statement of claim containing any false or misleading information is subject to criminal and civil penalties.","This document describes the main features of this plan.","Certain health care services such ashospitalizationoutpatient surgery can certain other outpatientservices, requirerecertificationwith Aetnato verify coverage for these services.","Also, it provides, or has an agreement with a hospital in the area to provide, any other medical services that may be required during the treatment period.","Accepts only patients with lowrisk pregnancies.","If selected for audit, the participant has the burden of establishing eligible dependent status to the satisfaction of the plan administrator.","An applicant who experiences a qualifying life status change may also be able to enroll outside the open enrollment period.","Form needed to request continuation of health and other optional insurances for military reservists.","However, such coverage may not be continued if the child has been issued an individual medical conversion policy.","However, you may not file a civil action unless you have exhausted the Medical Plans claims and appeals procedures.","How does an employee apply for these leaves?","If you access a hospitalemergency room for followup care, your expenses will not be coveredand you will be responsible for the entirecost of your treatment.","Search by job title, job category, location, or Military MOS code.","Information about the new ordinance regarding active military leave.","Aetna will take into account the expected duration of your disability payments and other relevant factors.","Aetna office, doing so would delay the processing of any enrollment changes.","Call the Central Office: Any UPS employee going on medical leave is required to call the central office immediately to report their leave.","BP Benefits through the wellbeing program will be maintained wholly separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellbeing program will be used in making any employment decision.","Services to treat errors of refraction.","To sync your meditation minutes, download the Provata VR meditation or Headspace app.","Citi will contribute money into your HSA each year that you are eligible.","It is carried out in a hospitalpsychiatric hospitalor residential treatment facility; on less than a fulltime inpatient basis.","BP Retiree Medical Plan to one that did, and you met retiree medical eligibility at the time you left the participating employer, your age and total vesting service in a BP retirement plan were used to determine your retiree contribution percentage.","To the first hospitalwhere treatment is given in a medical emergency.","You and your employer must fill out the appropriate paperwork in order to take it.","Employees who take leave to care for a seriously injured family servicemember are eligible for longer periods of covered leave.","An external review is a review by an independent clinical reviewer, selected by an External Review Organization, who has expertise in the problem or question involved.","Federal Drug Administration, as well as associated office visits, procedures, and other medical services and Durable medical equipment, orthotics and consumable medical supplies, including diabetic insulin pumps and tubing.","HMO has made or with the operation of the HMO.","Gums may appear red, swollen, and bleed easily during brushing.","You and any member of your household are automatically covered in the EAP.","Employees covered by collective bargaining agreements are subject to this summary to the extent consistent with the terms of BPs benefit programs, the applicable collective bargaining agreement and any applicable legal guidelines.","Not all brand name drugs have generic equivalents.","Has peer oriented activities.","Refer to your Schedule of Benefitsfor cost sharing information applicable to your plan.","Permit connectivity with social media networks to permit content sharing.","NIAGARA WATER may perform certain ministerial functions such as payroll deduction and forwarding employee premium payments to the insurer.","No other plan benefits will pay for nonemergency care in the emergency room unless otherwise specified under the plan.","You can also print RRA claim forms and receive general health information.","Immediately upon receipt of the request for expedited External Review, the Claims Administrator will determine whether the request meets the reviewability requirements set forth above for standard External Review.","Volume of each tier billed and total premium for each tier billed.","Approved Rehabilitation Program A rehabilitation program will no longer be an approved rehabilitation program on the date Aetna withdraws, in writing, its approval of the program.","There is no copay; there is coinsurance.","If an employee is eligible, how much leave is provided?","These technologies automatically identify your browser whenever you interact with our Website and Services.","The limits above may be extended only if Aetna and your employer agree, in writing, to extend them.","While you as the employer may pay for part or all of the premiums, COBRA does not require you to contribute to the cost of the coverage.","By using our Website and registering for one of our Services, you are agreeing to the terms of this Privacy Policy.","Homemaker or caretaker services.","All these benefits may be on offer in your new job, though they are not compulsory.","RRA will be considered to be if it meets federal tax law standards.","In our health plans, participating network providers are also required to give you access to your medical records within a reasonable amount of time after you make a request.","Be sure to review your dependents carefully to be sure all the eligible dependents you want to cover are included and that each of the dependents you enroll meets the requirements for dependent eligibility.","Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies.","Employees who go from part time to full time should be enrolled the day they become full time, once the probation period has been met.","You pay the full amount of the premium for dependent coverage.","Termination of dependent coverage as to your child for any reason other than reaching the maximum age under your plan.","MCMC is the final claims fiduciary for prescription drug appeals.","Make sure all eligible employees are included on the statement and that premiums are correct.","Contact your provider for their policy on completing disability forms.","At the time you request the leave, you must agree to make any contributions required by your Employer to continue coverage.","Preventive Care This section on Preventive Care describes the covered expensesfor services and supplies provided when you are well.","Has a physicianor certified nurse midwife present at all births and during the immediate postpartum period.","From your account dashboard, you can file a claim or request funds.","This includes estate planning and the drafting of a will.","The deductible does not apply to basic cleaning and is for children only.","So you can get the care you need close to home.","Medical Plan to one who did not, and you met the eligibility requirements for the BP Retiree Medical Plan while at the participating employer, you will continue to be eligible for access to retiree medical coverage at the time of retirement.","Chase Insurance Agency Services, Inc.","Such counseling services are covered expenseswhen provided in either a group or individual setting.","This program helps you manage your healthcare by putting you at the center of it all.","It is not a guarantee that benefits will be payable.","Health Insurance and Dependents can only be changed during Annual Enrollment or due to a Qualifying Life Event.","If you seek care in an emergency room for a nonemergency condition, the plan will not cover the expenses you incur.","End of COBRA coverage COBRA coverage will end on the earliest of the following dates: The last day of the maximum period of COBRA coverage.","Treatment of cancer by chemical or biological drugs.","Further, differences between this summary and the applicable plan document are not intended.","These are programs that offer you and your family even more flexibility and added perks on top of what you enroll in above.","All necessary information, including the appeal decision, will be communicated between you or your authorized representative and the claims administrator by telephone, facsimile, or other similar method.","Lost Your Health Insurance?","Disability Services specialists, nurses, and rehabilitation consultants will work with you, your physician, your People departmentrepresentativeto determine a course of action to get you back on the job.","Care provided by an outnetwork provider will be paid at no greater cost to you than if the services were performed by a network provider.","Create single site tracking.","Refer to your Schedule of Benefitsfor information on cost sharing amounts for complex imaging.","Dependents do not have to take part in the plan.","Need help with a specific HR issue like coronavirus or FLSA?","Be sure to register for telehealth now so you have quick access to care when you need it.","Colorado, Florida, Kentucky, New Jersey, Ohio or Texas.","PDF plugin for this browser.","If you or an affected dependent elects COBRA coverage, the BP Benefits Center will send a monthly bill to that individual.","Is directed by at least one physicianwho is a specialistin obstetrics and gynecology.","Specialty pharmacy If you use a specialty medication, the Prescription Drug Program offers an enhanced level of service for medications that are not available through a retail pharmacy.","Aetna withdraws, in writing, its approval of the program.","When Benefits are Payable Once you meet the short term disability test of disability described above, your short term disability benefits will be payable after the Elimination Period, if any, is over.","Not be legally married to, nor the domestic partner of, anyone else.","Services or supplies for which there is no charge.","Inpatient hospitalizationfor chemotherapy is limited to the initial dose while hospitalizedfor the diagnosis ofcancer and when a hospital stayis otherwise medically necessarybased on your health status.","You will then need to file a claim with ESI and submit it with your original itemized receipt for reimbursement based on plan limitations.","Once your RRA is depleted, you will no longer be eligible for reimbursement of any qualifying expenses; however, this would not impact your eligibility for coverage under the medical portion of the BP Retiree Medical Plan.","The date the claimant became disabled according to the policy or plan definition.","Test results should appear in your medical record kept by the hospitalor surgerycenterwhere the surgery is performed.","Savings PPO Option has two separate deductibles for network expenses, and two more for outnetwork expenses.","An insurance enrollment process that requires showing or demonostrating proof in hard copy that a student is properly insured.","Banner Health and Aetna Health Insurance Company and Banner Health and Aetna Health Plan Inc.","Your employer has claim forms.","Confidentiality Information contained in your medical records and information received from any provider incident to the provider patient relationship shall be kept confidential in accordance with applicable law.","If the volume of charges is not sufficient to produce a statistically valid sample, two or more three digit zip codes are grouped to produce a statistically valid sample.","See the HSA Quick Reference Guide for information on how to keep track of your contributions online.","Company Code is The site provides information on a variety of topics such as mental health and substance abuse, child and elder care referrals and more.","If the other plandoes not have this rule, and if, as a result, the plansdo not agree on the order of benefits, this rule is ignored.","Premium: The total premium for families enrolled in the plan.","You return from a leave of absence where you did not maintain coverage while on leave.","Please remember that you choose a health plan option when you enroll, not a network.","If upon the final standard level of appeal, the coverage denial is upheld and it is determined that you are eligible for External Review, you will be informed in writing of the steps necessary to request an External Review.","Fairview offers total rewards to fit your life.","Effect of Benefits Under Other Plans.","If you dont make a payment at the point you receive the service, you should wait for the claim to be processed through the claim system.","Administered as often as needed.","Surgery and reconstruction on the other breast to produce a symmetrical appearance.","You can also contact your broker or Aetna service representative.","Please refer to the Short Term Disability section for more details about your coverage.","You may not switch medical or dental options.","Health care services, supplies, treatments or drug therapies that have not yet been determined to be effective and safe in treating the illness or injury for which their use is proposed.","You must be under the regular care of a physician.","You want to yourself in coverage, or an eligible dependent to your coverage if you are already enrolled You are newly eligible.","Other adjustments: A list of other adjustments made at an account level.","Failure to give proof that the handicap continues.","Department of Health and Human Services.","RRA credits can be used to reimburse you for any medical expense.","Pet Insurance coverage for accidents and illness, as well as vaccination and routine care coverage, are available.","You or your dependents becomeeligible for premium assistance, with respect to coverage under the group health plan, under Medicaid or an SCHIP Plan.","Dependent coverage terminates as above.","Aetna NAP provider but not in the Aetna Choice POS II network.","There are no networks and no referrals needed.","The total net amount of the retroactivity and other adjustments to transactions.","These services and supplies may include: physical, speech and occupational therapy; biomedicals and immunosuppressants; home health care expenses and home infusion services.","You become vested in matching contributions after you are credited with three years of vesting services.","Guild to use as a reference for your employee benefits.","Keep more of your money each paycheck.","You do not need to pay up front and get reimbursed later.","Refer to the Understanding Precertificationsection for more information.","One of the four equal sections into which the dental arches can be divided.","The court will decide who should pay court costs and legal fees.","Please confirm that you want to proceed with deleting bookmark.","The individual deductible applies if you have You Only coverage.","You can change your health care provider at any time.","Only nonoccupational injuriesand nonoccupational illnessesare covered.","At least two eligible employees must take part, unless state laws require just one.","The coverage is automatic and begins on the first day of employment.","You are responsible for any expenses incurred over the maximum limits outlined in the What the Plan Covers Schedule of Benefitssections.","It does not provide benefits for all medical care.","In some cases, we may not be able to remove your personal information, in which case we will let you know if we are unable to do so and why.","When the BP Medical Plan is the secondary plan, the benefits paid by Medicare are subtracted from the benefits that would normally be paid by the BP Medical Plan.","Ask for a referral!","Mandated benefits are benefits that are legally required to be covered by either state law, federal law, or in some cases both.","Medical Plan, the contribution rates you pay for coverage depend on whether your disability was workrelated, when you were hired and whether or not you met the eligibility requirements for the BP Retiree Medical Plan at the onset of your disability.","Such reduced amount will be charged against any applicable benefit limit of this coverage.","See the HIPAA qualifying events section.","Operating and recovery rooms.","Reminder: Your employees can also print their ID cards from their member website at www.","If you have already satisfied the probationary period before you entered the eligible class, your coverage eligibility date is the date you enter the eligible class.","The plan covers only those services and supplies that are medicallynecessaryand included in What the Plan Coverssection.","The last day of the month for which your last contribution was made within the required time period.","Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.","If you elect a PPO Option and your covered dependent seeks care from outnetwork providers, those expenses will be subject to the PPO network deductible and the lower outnetwork benefit level.","An Adverse Benefit Determination based upon your eligibility is not eligible for External Review.","Savings Option, there is no separate prescription drug deductible.","Savings PPO and OOA Options: Express Scripts, Inc.","Child no longer meeting the eligibility requirements.","Covered expensesunder this Preventive Carebenefit would not include charges for a voluntary sterilization procedure to the extent that the procedure was not billed separately by the provider or because it was not the primary purpose of a confinement.","If you are a subscribed user, we will also collect your user preferences, such as the types of articles you would like to read.","Routine physical exams, routine eye exams, routine dental exams, routine hearing exams and other preventive services and supplies, except as specifically provided in the What the Plan Coverssection.","Unauthorized services, including any service obtained by or on behalf of a covered person without Precertification by Aetna when required.","Prepare a list of your medications, allergies and other doctors you see.","You or your covered dependents are eligible for, or have benefits available under, another plan that, in addition to the converted policy, would either match benefits or result in over insurance.","Fairview is committed to enhancing the health and wellbeing of Fairview employees and their families.","You must pay total premiums each month, as they are due, until the termination date.","You can only use the conversion option once.","The actual terms of your plan are spelled out in your plan documents.","For example, if you are an author, your personal information may continue to be published in connection with your article indefinitely.","Your contribution will be the full premium cost.","Call or email Member Services if you have questions regarding your statement.","PCD as needed for treatment and care.","You may have to pay for services at the time you receive them and file a claim with Aetna for reimbursement.","It is your responsibility to confirm that a provider or facility is part of the Aetna Choice POS II network.","You can file suit only after you have exhausted the plans claims and appeals procedures.","If your Employer grants you an approved leave for a period in excess of the period required by FMLA, any continuation of coverage during that excess period will be subject to prior written agreement between Aetna and your Employer.","Mainly provides skilled nursing and other therapeutic services.","If you would like to change how a browser uses cookies, including blocking or deleting cookies from the JD Supra Website and Services you can do so by changing the settings in your web browser.","Product: Displays only those products with active membership.","The STD policy defines eligibility requirements, elimination periods, and terms and conditions.","Change or reset your BP Benefits Center password.","Who does the employee need to care for during the leave?","Postal Service zip codes.","Such further medical examination and treatment, to the extent they are within the capabilities of the staff and facilities available at the hospital to stabilize the patient.","Benefit Determination or Final Internal Adverse Benefit Determination that you receive from the Claims Administrator will describe the process to follow if you wish to pursue an External Review, and will include a copy of the Request for External Review Form.","Own Occupation The occupation that you are routinely performing when your period of disability begins.","Something that replaces all or a portion of a human body part.","We will rely on you to notify us when you terminate the employee.","Filing your new claim should take about If someone else makes the call on your behalf, he or she will need to provide this information.","However, Aetna itself is not a provider of health care services, and therefore, cannot guarantee any results or outcomes.","Delta Dental by the dentist for predetermination prior to providing services.","Provides statistics on crime rates, cost and types of housing, age and more.","NAPdoctors include primary care doctors, obstetricians, gynecologists, radiologists, anesthesiologists, pathologists and other specialists.","How Coordination With Medicare Works.","Testing or training for educational purposes, including services associated with developmental delay or learning disabilities.","There will be no restrictions for waiting periods or preexisting conditions.","Click here for more details.","Written procedures for such a transfer must be displayed and the staff must be aware of them.","It does not include drugs on the Formulary Exclusions List.","The Human Resources team at Rice University is committed to providing university faculty and staff with comprehensive information regarding benefits and other university services.","Rule that determines the benefit amounts available to retired employees.","Of income you receive from any work for pay or profit.","How is your information shared?","You must fill your prescription drug at an ESI network pharmacy unless one is not available in the area.","Final External Review Decisionis a determination by an ERO at the conclusion of an External Review.","The Hartford is now managing your disability and leave benefits.","They are an alternative to a office visit for treatment of: Unscheduled, non and The administration of certain immunizations; and Individual screening and counseling services.","You may be eligible to change your benefits.","In addition, insurance premiums are not an eligible medical expense for your HSA, though there are exceptions for longterm care coverage premiums and some types of retiree health premiums.","You are rehired in the same plan year.","Refer to your faculty manual for guidance.","HSA and have an available balance in your account.","Treatment of impulse control disorders such as pathological gambling, kleptomania, pedophilia, caffeine or nicotine use.","Any related services including processing, storage or replacement costs, and the services of blood donors, apheresis or plasmapheresis are not covered.","Providesa level of skilled intervention consistent with patient risk.","BP medical coverage, but you may not participate in the HCFSA for the remainder of the plan year.","These services may also be obtained from your physician.","Once completed you can sign your fillable form or send for signing.","To our affiliated entities and in connection with the sale, assignment or other transfer of our company or our business.","Retirement benefits from the Federal Social Security Act.","When a member is evacuated to an appropriate medical facility due to an emergency medical situation.","These deductibles are exclusive of each other.","Monthly prorating applies when you are hired by, or if you leave, BP in the middle of a plan year.","The planthat covers a person as anemployee who is neither laid off nor retired or as a dependent of an active employee, is theprimary plan.","Links to outside sites are provided for your convenience only.","ID card in advance to make sure the procedure is covered by the plan.","Personal information does not include publicly available information or information that is available or reported in a summarized or aggregate fashion but does not identify the member.","Medicare Fee Schedule for that area.","Section above, JD Supra may share your information with third parties.","It is often used when employees have been out of the workforce for a long period of time, and with individuals who have learning or psychiatric impairments.","The date the coverage involved discontinues as to your eligible class.","Prevailing Charge Rates: These are rates reported by FAIR Health, a nonprofit company, in their database.","The tissues surrounding the end of the tooth root.","Aroutine eye exam does not include a contactlens exam.","If a period of time is not indicated, Aetna will prorate the payments over a reasonable period of time.","You will also need to agree to make required contributions for any contributory coverage.","See Home delivery program for more information.","The accidentmust occur while the person is covered under this Contract.","Such documentation may include birth and marriage certificates, civil union or domestic partner registration materials, drivers licenses, passports, divorce decrees, court orders, tax records or other documents or materials supporting eligible dependent treatment.","PCP that direct a member to a participating health care professional for medically necessary care.","Only vesting service accrued with the participating group will be used to calculate your retirement subsidy.","Nonmedicallynecessaryservices, including but not limited to, those treatments, services, prescriptiondrugand supplieswhich are not medicallynecessary, as determined by Aetna, for the diagnosis and treatment of illnessinjury, restoration of physiological functions, or covered preventive services.","Maintenance and repairs needed due to misuse or abuse are not covered.","If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage.","Your dependent no longer qualifies as an eligible dependent; You become entitled to Medicare; or You die.","If an employee is away from work because of illness or injury on the date any coverage other than health coverage would have taken effect, coverage does not start until the employee returns to work for one full day.","If you need a duplicate card, contact the appropriate vendor to make the request.","Premiums for continued coverage will be required.","Under a MCSO, if you are the noncustodial parent, the custodial parent may file claims for benefits.","Because PPO network providers are responsible for obtaining precertification of care for you, precertification penalties do not apply under the BP PPO Options for eligible care received from a network provider.","Coverage under your plan can end for a variety of reasons.","The part of a lump sum or periodic payment you receive for disability will be counted as other income benefit, even if it not specifically allocated or identified as such.","Accredo will contact you if the medication youre taking can be supplied or is required to be supplied through the Accredo program.","If you speak another language, assistance services are available to you free of charge.","Your group plan can be terminated if not enough employees take part.","Visit your health care provider, and give him or her a copy of the completed authorization form which we have enclosed.","Short term disability coverage does not cover any disability on any day that you are confined in a penal or correctional institution for conviction of a criminal act or other public offense.","Members are free to change this selection at any time.","Penalties may include imprisonment, fines, denial of insurance, and civil damages.","At least one physicianmust be on call at all times.","The Preferred Drug List is subject to change.","Employee Benefits oversees the administration of all medical, dental, life, and disability as well as voluntary benefits programs for Shelby County Government.","For an urgent admission: You, your physician or the facility will need to call before you are scheduled to be admitted.","Savings PPO Option Office visit copays.","They provide customer service and administer the prescription drug programs such as Step Therapy, Prior Authorization and Drug Quantity Management.","Expenses not covered under the BP Medical Plan for all other limitations and exclusions.","Please use the appropriate form when requesting a FMLA leave.","Selfreported or manually tracked minutes will not be applied toward the goals.","Glossary Defines the Terms Shown in Bold Type in the Text of This Document.","Other provider acting within the scope of their license.","You must make at least one attempt to contact and resolve your issue directly with the appropriate claims administrator before contacting the Advocacy Service.","BP retirement program at the time of death.","Through our partnership with United Way, we proactively inform your employees of additional support services if needed.","Note that simple unavailability later in the year, either via travel or business reasons, will not be a reason to request an alternative process.","Your work hours are reduced.","Direct Deposit Agreement with attached deposit slip or voided check.","Savings OOA Option Office visit copays.","Only devicetracked activity will count towards active minutes.","Adverse Benefit Determination for which the internal appeals process has been exhausted.","Both of these opportunities are voluntary to you, as is participation in the wellbeing program overall.","Plan type: The unique identifier code for those products with active membership.","There is a late enrollment penalty if you do not enroll in Medicare Part D coverage when you are first eligible unless you have creditable coverageunder an employer group health plan.","Employees, spouses, and children who have their medical care at St.","Lab, Xray and anesthesia.","ASPCA Pet Health Insurance.","How can we as plan participants contain cost and save more?","Application to Change Elem.","Please contact us for other exceptions that may apply.","The program allows you to receive support with navigating healthcare, creating a care plan and optimizing your health benefits.","Want to learn how your lifestyle habits affect your health and wellbeing?","You are a regular fulltime employee, as defined by your employer.","Your contributions will be deducted from your paychecks throughout the year.","If there is an overpayment, you must repay Aetna the overpayment the difference between all overpayments and the benefit payable amount.","It may also say that you need to take the steps necessary to maintain your health insurance during your leave.","Auto, homeowner and pet insurancehomeowner and pet insurance are direct pay plans, meaning you will pay the vendor directly.","You will receive notification of what the plan has paid toward your coveredexpenses.","Attention Florida Residents: Any person who knowingly and with intent to injure, defraud, or deceive any insurer, files a statement of claim or an application containing any false, incomplete or misleading information is guilty of a felony of the third degree.","We are an equal opportunity and affirmative action employer.","Residents: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application is guilty of a crime and may be subject to fines and confinement in prison.","CVS Health family of companies.","Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.","Your physician can document on your form that those areas have been discussed and are being managed, which would still qualify you for the additional plan contribution.","If the deadline on the form has passed, wait until the next round opens up before completing.","Autism Spectrum Disorder when ordered by a physician, licensed psychologist or licensed clinical social worker, as part of a treatment plan; and the covered child is diagnosed with Autism Spectrum Disorder.","Has the capacity to administer a local anesthetic and to perform minor surgery.","Develops a hospice care programto meet those needs.","Either Aetnaor any network providermay terminate theprovidercontract or limit the number of patients accepted in a practice.","We use cookies to give you the best possible online experience.","Eligibility information and signed beneficiary records from your employer.","It is supervised by a psychiatric physicianwho weekly reviews and evaluates its effect.","We are committed to maintaining a diverse and inclusive workplace.","Hospital and Clinics and North Memorial.","Set up online billing, and start viewing and paying your Aetna bills right online.","If you want to cover a domestic partner, be sure to call the HMOs member services department for information before you enroll in the plan.","Your employment stops for any reason, including job elimination or being placed on severance.","You can ask to review details about the information we hold about you and how that information has been used and disclosed.","The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report.","You will be subject to the deductible andpayment percentagethat apply to outofnetwork expenses, which may result in higher outpocket costs to you.","In addition to creating rights for plan participants, ERISA imposes duties upon the people who are responsible for the operation of the plan.","Any biomechanical external prosthetic device or replacement of external prosthetics due to loss, theft or destruction.","Funded solely by St.","Your contributions will be deducted from your pay.","Unless specified above, not covered under this benefit are charges incurred for services and supplies furnished: In a group setting for screening and counseling services.","For information on precertification, contact your plan administrator.","For inpatient services, medically necessaryfurther means that an individuals medical symptoms or condition requires that the diagnosis or treatment cannot safely be provided to the individual through outpatient services.","Need to order forms?","If later changed, the new classification will only apply prospectively, regardless of the actual hours worked under the initial classification.","This is the beginning stage of periodontal disease.","Validates recapcha and resubmits the form.","Say, for example, your group plan includes health coverage.","It may include important information about your agreement and payment terms.","Electronic signatures are allowable as long as they are present on the standard Aetna enrollment application.","If you call to precertify additional hospital days beyond those initially precertified, but the claims administrator determines that those additional days are not medically necessary: No benefits will be paid for the additional days.","Urgent care facility copays.","Due to an illnessor injurywhich makes leaving the home medically contraindicated; orecause the act of transport would be a serious risk toyour life or health.","Not all prescription drugs are covered by the VUMC Health Plan.","We use the information and data we collect principally in order to provide our Website and Services.","It shows, for example, how to add new dependents or end coverage when employment ends."]